I recently wrote about my own episode of acute low back pain and how I was able to rapidly improve my condition with the right exercise. I continue to improve with my exercise and posture correction and should be back to normal in a few more days.

I did receive an interesting comment about my post by an astute reader on Twitter. He noted that perhaps I should not have stated that the press-up exercise helps to "keep the discs in place." I think this reader is right. There is no evidence that the press-up puts or keeps the discs in place. But, the intervertebral disc may be a culprit in my painful low back condition.

You see, when bending forward, internal disc pressure is increased, and when I bent forward to untie my shoes, I felt intense pain, so naturally I felt that I pushed part of a disc a bit out of place, and I needed to perform a press-up to push it back into place. The beauty of the disc theory as a cause of my pain is that it is easy to understand. It is just difficult to prove that the disc out of place event really did occur. Even with advanced diagnostic tests, I cannot state with accuracy that the disc, or any other structure in my back, casued my pain.

My low back condition should really be simplified. In essence, my back went out when I bent forward. I needed to bend backwards (with the press-up exercise) to put my back in place. It seemed to help, so I continued to bend backwards and maintain good posture. This seems to be helping me get better. The goals of treatment for my back are to put my back in place, keep it in place, slowly and safely return to normal activity and function, and prevent future episodes of low back pain. Easy peasy.

Since we don't really know what structure casued my back to hurt, my condition should be referred to as non-specific low back pain.

I always appreciate it when readers help to keep me focused and on track. You can join the discussions on Twitter or Facebook as well. The message boards in my forum are also a good place to interact and connect with others who are interested in physical therapy.

A few days ago I went seine fishing with a good friend of mine in the Hudson River. We were just looking for small fish to help out with an environmental day at our children's school. We met in the morning and sloshed around in the mud of the beautiful river for about an hour or so.

When we were finished, I drove home, walked in the door and bent down to untie my shoes. Bad idea.

When I bent down I felt a sharp pain in the middle of my low back. My wife immediately saw the painful grimmace on my face and she knew that I was hurting.

Luckily, I knew exactly what to do. I quickly got down on the kithchen floor on my belly and started performing basic press-ups for my back. This is a simple back exercise designed to keep the lumbar discs in place. After a few reps of press-ups, I could stand up straight. I was still hurting a bit, but I knew that I had to perform press-ups and maintain posture for a few days the help my condition.

After a few days, I am still a bit sore, but my condition is improved greatly. I has me thinking about the millions of people who suffer a similar fate as mine. You know, when the simple act of bending over to tie your shoes or pick up a piece of paper results in a lightning strike of pain across your low back. I feel for the people who felt that same pain and did not know what to do immediately.

I often assess and treat patients who tell me about the many different things that they have been told about their low back pain. Some are told to rest in bed, some are told to stretch it out, and others are given pretty potent (and addictive) medication to help treat their condition. Many people try spinal decompression machines or inverted traction machines, but often with little success.

What if everyone who had acute low back pain was instructed in proper posture and in the correct exercise for their specific condition? What if those people were given the opportunity to engage in an appropriate self-care program for a few weeks? Would we see fewer and fewer chronic low back pain sufferers?

I am thankful that I knew what to do immediately and was able to start treating my back pain seconds after it came on. I feel better each day, and I am sure that in a few weeks my back will be functioning normally once again. (I'll just need to remember to keep exercising my back to prevent future painful episodes.)

Hundreds of physical therapists, physical therapy assistants, and PT students are expected to converge on Albany, NY today for Lobby Day. The therapists will be meeting with New York State lawmakers to discuss current legislation that would limit co-payments and out-of-pocket expenses for consumers of physical therapy.

Many insurance compaines designate physical therapists as "specialists," and therefore patients are required to pay a higher specialist co-pay. Higher co-pays and out-of-pocket expenses act as a barrier to physical therapy care. In some cases, patient's personal payments exceed the amount that is actually covered by the insurance company. That means that some patients pay 100% of the "co-pay" while the insurance company pays nothing for physical therapy services. The new law would limit the amount that a physical therapy patient would be required to pay thus allowing for greater access to physical therapy services.

To learn more about this year's Lobby Day, visit the New York Physical Therapy Assosciation website.

This morning a patient phoned my clinic and wanted to make an initial evaluation appointment right away. She said she had a total knee replacement about three weeks ago and was currently receiving physical therapy services at home. She had been progressing well, but her doctor wanted her to continue with physical therapy in an outpatient clinic to maximize range of motion (ROM) and strength in her knee so that she could walk better.

This particular patient lives about one block from a physical therapy clinic, but states that when she called to make her appointment there, they were unable to see her for eleven days. The patient knew that to maintain the positive gains that she had made thus far, she would need to be working in physical therapy sooner rather than later.

Luckily, I was able to see this particular patient today, and she had her initial evaluation and treatment done before lunch. She was set up with a home exercise program to keep working on her strength and ROM independently as well.

So how long should you wait to see your physical therapist? After a total knee replacement, it is important to gain maximum ROM and muscle activation and strength as soon as possible, so a waiting period of eleven days is a bit much. I know that some people have chronic conditions and may be able to wait a few weeks before starting therapy, but for the most part earlier rather than later access to care is best for most conditions.

If you need physical therapy, don't simply wait for the next available appointment time at a clinic, especially if it is more than a week away. Call around to a few different clinics near your home and ask how soon they can accomodate you. The sooner you get a plan in place and start working in physical therapy, the better off your outcomes are likely to be.