Low Back Pain Relief
Low back pain (LBP) is one of the most common conditions that health care professionals treat in the United States. 80% people will experience LBP during their lifetime. 5-10% will then develop chronic low back pain that lasts more than three months. This is a serious problem that affects millions of people. How can we stop it from happening?
Low back pain can be an inevitable part of life, and can be a positive part in the right situations. The ability to feel pain can help us know when to slow down and check for injuries. Acute pain, which is pain that occurs within a few days to weeks after an injury, acts as an alarm system in the body. Chronic pain is pain that lasts beyond normal healing times.
LBP is a fascinating condition. In just a few weeks, over 90% of LBP cases will be completely healed. The best treatment is to live normally again.
Did you get hurt while gardening? It's okay. Your back will get better over time if you keep moving. Do not try to set a personal record in deadlifting, or start trampoline basketball. However, don't sit down on the couch and eat Aleve.
Fear of making things worse is the most common objection to the "keep moving" recommendation. This is normal. You can find horrific stories on the internet about low back pain that causes paralysis or is a precursor for cancer in just a few clicks.
These are exceptions and not the norm. Good healthcare providers will look for red flags and provide the right care.
What is the right care? Read on to find out…
Here are some myths that I believe to be false. My goal is for you to have the tools and resources to manage your health. You can find a lot of misinformation online about pain and how to treat it. To relieve pain, you don't need to use injections, adjustments or massage guns. Most cases can be managed by you on your own. Sometimes you may just need some guidance.
DISCS DON’T SLIP. YOUR BACK IS STRONG.
Let's begin with the most common myth about low back pain: A disc has slipped.
Although the MRI is a remarkable invention that can save lives, it can also cause unnecessary harm or cost billions in healthcare dollars. "Poor” MRI findings can cause people to have unnecessary surgery, take unnecessary medication, and avoid the activities they love. It is actually the things they are forbidden to do (e.g. Run, hike, lift weights, and play sports) that will decrease pain, increase strength and body resilience and often reverse any worrying findings from an MRI.
The slipped disc, also known as a herniation, is the most important of these discoveries.
There is a good chance that if an MRI is done on your low back tomorrow, it could show a combination of disc bulges, arthritis, decreased space (stenosis), bone spurs and osteophytes. These abnormal findings are normal as we age, they are not uncommon. It is normal for our bodies to age; it is part of living. While most people suffering from back pain have normal MRI results, a large percentage of those without pain (asymptomatic), have " abnormal reports."
An MRI can often prove to be more damaging than helpful. Patients with low back pain may have poor outcomes if they are given an MRI. Fear-avoiding behaviors are triggered by the MRI. Patients fear moving and fear that they will be "damaged" further. In reality, a lack of movement can often worsen symptoms and delay recovery.
Our bodies are resilient and strong. While stenosis and severe herniations may not be a problem in all cases, it is important to live a healthy lifestyle that allows you to move as you wish. Did you know that herniations can heal themselves?
Stop moving is the worst thing you can do to lower back pain. The second myth is the one I want to share with you.
ROUNDING YOUR BACK IS SAFE.
Some phrases are not good for injury prevention.
A rounded low back, also known as lumbar flexion, is not a sign of a back injury. A recent study analyzed over 4500 articles to find out what the research says about lifting with a round low back. Here's what they found:
"There was no association between lifting and lumbar spines developing severe low back pain. LBP did not affect peak lumbar flexion when lifting. The current advice not to lift with lumbar flexion to reduce low back pain risk does not have any evidence.”
Translated, lifting with a round low back doesn't cause or sustain low back pain.
Training in workplace ergonomics to reduce lumbar flexion is not effective. It is not worthwhile to train people to be straight. It is rare to find the right answer by focusing only on one cause of pain or injury.
Low job satisfaction, inactivity, poor exercise tolerance, and low job satisfaction are all more concerning than lifting techniques when it comes to work-related pain. Injuries, in general, are mainly caused by overload and poor recovery.
While this does not necessarily mean that you won't get hurt if you do too many deadlifts using a rounded back, the injury is most likely to be caused by excessive demands placed on your entire body and not the spine (deadlifts can be very strenuous). Instead of focusing on lifting techniques and not on your overall health, you should be focusing on your exercise and overall health. Research reveals exercise as one of the best treatments for back pain at the workplace (you'll start to see a theme).
YOUR POSTURE DOES NOT IMPACT YOU.
Current research doesn't support the notion that posture is a cause of pain. Simply standing straight will not prevent or eliminate pain.
Our bodies are resilient and can withstand sitting for a while in a slouched posture. What about the "texting neck", imaging that scares people about the excessive forces being placed on your spine? Nope. Your spine and muscles are giggling, saying "Is this all you have?"
Self-prescribe movement and breaks from sitting, instead of spending money on copper-infused braces or fancy chairs is more effective than maintaining a straight, rigid spine 24/7.
SURGERY, INJECTIONS, AND MEDICATION DO NOT PROVIDE THE ANSWER.
"There is very little evidence to support the efficacy of invasive procedures for chronic pain.”
This quote is based on a 2019 research study, which gathered the results from 25 research trials. These trials included surgery for low back pain.
Research indicates that post-operative care is more successful if there are good psychosocial factors.
Patients who have high levels of kinesiophobia (fear of movement) and pain catastrophizing (constant focus and anxiety about pain and feeling helpless) are less active. Surgery doesn't eliminate our anxiety, fears, and self-doubt. A personalized treatment that is centered on movement is required for this.
The issues are the same when we move to medication. Side effects and not the root cause of chronic pain are what medicine does. Although medication is an effective tool for pain management, it shouldn't be the first or only line of defense.
This is the main reason for the U.S.'s current opioid crisis. The Centers for Disease Control (CDC), has tried to reverse the current opioid reliance. In its Guideline for Prescription of Opioids for Chronic Pain, the CDC stated that there are too many side effects and the addictive nature of these drugs makes them unsuitable as a first-choice treatment.
REALIGNMENT IS NOT A REQUIRED.
Research does not support the notion that our bodies are out of alignment. We don't need to be balanced. Our bodies are adaptable and resilient (have I mentioned that yet?).
Your body changes according to what you put on it. It is normal and healthy to be " imbalanced" with more strength and mobility on one side than the other. This is especially true if you were involved in any sport growing up that was very one-side dominant. It doesn't matter how our bodies align. Fitness, nutrition, and mental health are the most important.
Healthcare sometimes compares our bodies to cars and requires regular maintenance.
The ability to adapt is a key distinction between a car and a body. Cars can only be destroyed. You cannot increase the car's endurance by taking it on a road trip. Drag racing or climbing hills will not increase a car’s horsepower. Weightlifting and sprint training will not increase a car's horsepower. High-quality gasoline can enable a car to run optimally. Also, high-quality nutrition can increase the body's capacity.
Cars also require someone to maintain them. Your body is yours. While a physical therapist can assist you in certain situations, you ultimately have control of your body.
So, what should you do? You guessed it: MOVE.
Studies have shown that activity and exercise are the best medicines for bones and joints for Cartilage Health.
What kind of exercise is that?
No matter your age, both moderate and vigorous exercise are recommended. You don't have to get barbells in order to be healthy.
Recent research shows that walking can be just as effective for low back pain treatment as any other exercise. It can also aid in bone health, endurance, depression, anxiety, and mood stabilization.
Engage in activities and exercises that you love. You are more likely to keep doing it if you love it. Work with a personal trainer or physical therapist to ensure they work towards your goals. They should also incorporate the activities that you love. You won't need to do a lot of work to build muscle and strength. Walking can't, but you can customize your workouts.
LBP cannot be completely solved by stretching. Your LBP may not be caused by inflexibility. Contrary to popular belief, stretching and mobility exercises in isolation don't reduce the likelihood of injury. Studies have shown a potential injury-protective effect of multimodal approaches. This means that stretching when combined with an active warmup may prove to be beneficial. It is fine to stretch - it can be enjoyable - but not as a sole treatment.
Pain is a personal experience. Every person's pain will be different. There are many conservative treatments that don't have the side effects of surgery or medication. Focusing on exercise and nutrition as well as sleep and emotional Health (stress relief, happiness, purpose, etc.) will help you to be more productive. You will increase your body's ability to resist future challenges.
You may end up experiencing the same problems over and over again if you try to find a quick fix for low back pain. You can keep moving and the pain will go away in a matter of hours or days. Reach out to PAR5PT if you have concerns about the future or feel that an injury has occurred.
Our goal is to empower you to live the life that you desire. Our physical therapists are able to help you understand pain and build strength. They can also help you navigate the maze of health misinformation.
For more info, contact PAR5PT to get the conversation started.