Aquatic Therapy in the Management of Chronic Low Back Pain

Assessment and Diagnosis

1.      Subjective History – it is important to gain a subjective history from the patient regarding their back pain such as onset, duration, location, character, aggravating and relieving factors and severity- more about subjective history can be found here

2.      Physical Assessment

a.      Observation – posture, abnormal deformity, and curvature

b.      Palpation – along spinous process and transverse process, musculature, sacroiliac joint

c.      Gait – through stance and swing phase

d.      Range of Motion – Passive and Active of lumbar, thoracic spine, and hip

e.      Muscle strength – Lumbar spine and Hip

f.       Neurological testing – Reflexes, Motor and sensory testing, straight leg raise, femoral nerve test

g.      Testing SIJ and Hip – thigh thrust test, pelvic compression, FABER’s

h.      Motor control testing – Waiter’s Bow, Pelvic tilts

i.        Imagining is not routinely offered in non-specialist setting for people with low back pain – NICE

3.      Patient-reported outcome measures

a.      Physical function – Oswestry Disability Index or Roland Morris Disability Questionnaire

b.      Pain intensity – Numerical Rating Scale or Visual Analogue Scale

c.      Health-related quality of life – Short Form Health Survey 12 or EuroQol-5D-3L

d.      Work – Work Ability or Work productivity questionnaire

e.      Psychological functioning – Hospital Anxiety and Disability Scale

f.       Pain interference – Pain Interference subscale of the Brief Pain Inventory