Low Down on Low Back Pain
Back pain is one of the most common diagnoses we see as Physical Therapists. Nearly everyone at some point has back pain that interferes with work, routine daily activities, or recreation. Back pain is the most common cause of job-related disabilities and a leading contributor to missing work. It is the second most common neurological ailment in the U.S., second to the headache. Generally back pain goes away in a few days. Unfortunately, at times, it takes much longer to resolve. In this edition of “Promoting Healthy Lifestyles”, we will explore some of the myths of low back pain.
Myth: Bed rest is the best treatment for low back pain.
Fact: An updated review in the Cochrane Library, which examines medical research, concluded that normal daily activity is better than bed rest. Active patients experience less pain and avoid the side effects of immobility.
Myth: MRIs are necessary if you have back pain
Fact: An anatomical abnormality that is seen on an imaging test (MRI, CT scan) is not necessarily a cause of your back pain. In fact, the vast majority of people who never have had an episode of back pain will have abnormalities (such as a herniated disc or degenerative disc) on an imaging test. Most health professionals can develop a successful treatment approach based on a thorough medical history and physical examination. Only specific symptom patterns in a minority of cases indicate the need for MRI scans or other sophisticated tests. Typically, MRI scans are used when patients are not responding well to appropriate treatment
Myth: I have back pain, so I will need surgery
Fact: Only a very small percentage of people who have back pain will undergo surgery. Unless you absolutely need an emergency surgical procedure, surgery for back pain should be the very last solution to consider remedying your back problems. To put it in perspective, in the US, some 450 cases of a herniated disk per 100,000 require surgery.
Myth: There is nothing you can do about the pain; you just have to learn to live with it.
Fact: Research has shown that exercise and manual therapy have been beneficial to many patients (you say shown here twice). In addition, patient education about causes and prevention of your back pain, as well as utilizing appropriate body mechanics, is beneficial. Physical therapists are trained to identify which of these treatment strategies will be most effective for an individual patient, which further improves the effectiveness of care.
There are many myths associated with back pain and its treatment. Education is the key to both understanding current episodes of back pain, as well as prevention of future flare ups. Please feel free to e-mail me with questions, comments, or ideas for future topics in “Promoting Healthy Lifestyles”.
Perry Koslow, PT, MPT, CSCS CKTP is Facility Director of ProCare Physical Therapy in Moscow and adjunct faculty at the University of Scranton. You can email him at firstname.lastname@example.org