Back Pain Facts

In spite of extensive research proving that the most effective treatment for most cases of chronic back pain is to strengthen the muscles that support the spine, we still hear many myths about back pain and back pain treatment. Why is this?

When someone experiences back pain for the first time, especially an acute episode with severe spasms, it can be a very painful and frightening experience. If pain is chronic it is not only physically debilitating, but also emotionally draining. It is easy to see how patients in these situations would be vulnerable to the suggestions of whichever health professional is consulted.

That is why some physicians refer to the treatment of chronic back pain as "an industry"**. As one physician at New York's Hospital for Special Surgery put it: "If you are holding a screwdriver, everything looks like a screw". So, if you see a surgeon, they may recommend surgery, a chiropractor may recommend a series of adjustments, a pain management specialist an injection for pain, etc.

Doctors who have studied the problem have concluded that patients need to be given unbiased information on what is known and not known about back pain and the ways to treat it.  

In this regard, here are some of the things that we know about back pain:

An acute episode of back pain usually dissipates in a day or several weeks. It is best treated by icing the area at 20 minute intervals for the first 72 hours to help manage inflammation and swelling. After 72 hours, switch to heat to calm the muscles. Do not remain immobile, however. It is best to move as much as you can as soon as you can to promote blood flow and to combat further weakening of the muscles, which will slow recovery and make it easier for the next injury to occur. An over-the-counter anti inflammatory may also be prescribed.

Back pain is defined "chronic" when it persists beyond 3 months or when someone has several acute episodes in a year. For most cases of chronic back pain we know that:

1. People on bed rest have MORE pain and SLOWER recovery than those who stay active.

2. Referral for MRI's, CT's or Radiography is rarely indicated. A recent study published in The Lancet found that patients with low back pain who underwent imaging studies did no better than those who did not. What shows up in an imaging study often has NOTHING to do with what is causing the pain. Most of us on our thirties and beyond have degenerative changes in our spine and many of us also have herniated discs, yet some of us have pain and some of us do not.

3. The most effective treatment for most cases of low back pain, including associated leg pain, is physical therapy specifically designed to strengthen the structures that support the spine, together with education regarding posture and simple home exercises that can help to maintain the gains made in therapy. In some cases over-the-counter medication for pain may be prescribed. In a small number of cases where pain makes therapy too difficult, an injection by a spinal pain management specialist may be needed to allow therapy to progress.

In very rare cases, such as where a person is experiencing drop foot, loss of control of bladder or bowel function or acute spinal fracture, surgery may necessary. These types of cases can usually be diagnosed by a history and a physical and, with respect to suspicion of fracture, an x-ray.

** One in four Americans claim to suffer from chronic back pain and the cost of back pain is estimated at $30 to $70 billion annually!

For more information about this article or a free consultation, call Kathleen Casey or Darlene Wooldridge at Back To Health Physical Therapy (954) 565- 0075.

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