To Your Health
September, 2010 (Vol. 04, Issue 09)
Research suggests that when it comes to back pain, early intervention is best. There are many reasons for this concept, but here is a basic summary of what current guidelines are saying:
- Low back pain can sometimes be due to something more serious than a simple sprain. That's why it's important to see your chiropractor right away so they can evaluate you for anything more serious.
- Spinal manipulation is one of the only treatments that is consistently being recommended for those with acute low back pain - and yet far too many people don't visit a chiropractor and choose to pop over-the-counter pain medication instead.
- Avoid bed rest as much as possible. Yes, I know that it feels good and frankly, when I had an episode of low back pain once, I was tempted to lie in bed all day, too. On a basic level, it's the most "rational" thing to do. However, bed rest actually wastes away your muscles, and this effect lasts even for the lucky ones who improve with their low back pain. For those who are pain free, the bad news is that the muscles still waste away.
What does this mean? It means that although you may be lucky enough to be out of pain, your muscles will have put you in a position where you will most likely suffer back pain again. That's why trying to stay as active as possible in the early stages can go a long way not only to get over the back pain, but also to help prevent future back pain episodes from happening.
Early exercise will help ensure that your muscles and bones will continue to move to prevent stiffness and pain. I often have patients tell me that they have Googled an exercise program for their back pain and are using it. Unfortunately, there is no-one-size-fits-all exercise program for low back pain. The type of exercises you do for a disc herniation can be totally different than the ones you do for a simple strain or sprain caused by playing a sport or lifting something at work. In fact, some exercises that you may see posted on the Internet may actually cause further damage or prolong your back pain. That's why it's so important to see your health professional to get an expert opinion on which exercises will be beneficial for your condition.
- There are ways to predict if acute pain will end up developing into chronic pain. One of the most frustrating things health professionals face is the fact that although some patients may have undergone treatments, they still develop chronic low back pain. The good news is that there are certain predictors that can identify someone who may end up developing chronic back pain. When you look at these, it becomes more apparent that seeking treatment and following all the above points is crucial to getting better. One of the biggest predictors is called "pain avoidance behavior." Quite simply, it means once you get the pain, you will do everything you can to avoid anything that will cause pain.
What happens next? You guessed it. This type of person lies in bed as much as possible. This type of person will try to avoid any exercise that may cause the slightest discomfort. Essentially, they will avoid everything that could be helpful to their condition. That's why I always take time with my patients to stress the importance of not letting the pain overtake their lives. Continue doing what you did before, no matter how small of an effort you put in. The back pain feels like your back is going to break in two. However, with proper supervision and the right recommendations for treatment, you will not be able to damage your back any more than the situation it is in.
So, the next time you experience back pain and feel like you can't do anything, always remember that any movement or activity or treatment that keeps you moving is crucial for your recovery. Another factor is that you may be deconditioned and not fit enough. With back pain, you can become even more deconditioned. That's why starting to move and then progressing to an exercise program is crucial to ensure not only that you get better, but also that you don't get future bouts of low back pain.
CHRONIC LOW BACK PAIN: Focus on strengthening and endurance exercises
Chronic low back pain is pain that has been persistent for more than three months. Most of my patients have either tried different therapies with no results, or have decided to use the "wait and see" approach that we just discussed. Regardless of how you got here, there are several key things to remember about your back pain if it's chronic:
Most back pain does not require surgery. Some of my patients with chronic pain are always looking for the surgical solution. Who wouldn't? We all will believe that if someone just takes what is causing the pain "out," everything will be fine. Unfortunately, surgery doesn't have a stellar track record of finding a cure for your chronic back pain. Most surgeons I know and work with will tell me straight out that it's the last option for the patient. For example, some of my disc herniation patients with nerve root problems may feel like surgery is the only option, but then are surprised when the surgeon holds off. One thing you have to realize is that surgeons will only do surgery if there is physical damage occurring to the nerves that are causing muscle wasting and will lead to irreversible damage. Pain is not a criteria for surgery!