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Lower Back Pain

By: Dr. Patrick Schroeder, PT, DPT, OCS


Raise your hand if you have dealt with back pain at some point in your life! Odds are that you have, as low back pain is the third most common reason for a medical visit in the United States(3).


Needless to say, this is something that has a tremendous impact on the lives of many. The goal of this blog is to give you an overview on some important facts related to back pain, and some advice if you are dealing with a spinal issue. There is a lot of conflicting information online about low back pain often making it confusing for individuals to figure out what is really going on and what is the best way to manage it. This can be very frustrating and often cause fear or hesitancy for people. Below are some facts, followed by some things you can do to help take control of your situation.



FACTS


  • The vast majority of people improve! Studies show that after an acute onset of lower back pain the vast majority of people will experience significant improvement after one month, with that number increasing even more up to three months(2). This is important to realize as back pain can often be scary, causing negative thoughts to creep into your head. It is important to remind yourself that this is a normal thing, and has tremendous potential for improvement with some time and exercise.

  • Don’t overreact to your MRI results! There are many abnormalities found on MRI’s that are very common in pain free people. A recent systematic review showed that 37% of asymptomatic 20 year-olds had evidence of spinal disc degeneration, along with 96% of 80 year-old individuals demonstrating some degree of degeneration. In addition 30% of 20 year-olds had evidence of a disc bulge on MRI, compared with 84% of 80 year-olds. This shows that these findings on your MRI are very common, particularly the older you are, and prove that they are not always painful. This can give you optimism knowing that a positive finding on an MRI does not guarantee that you will be living in pain. Furthermore, studies have shown that people recover just as well from a lower back injury regardless of whether or not they received an MRI.(1)

  • Oftentimes there are non physical things that can contribute to back pain. Two of the most common ones are anxiety/stress and a lack of sleep! If you find yourself struggling in either of these areas, addressing these can help your back pain! It is helpful to know that back pain can be more than just a physical issue, and that mental health can have an impact as well(4).


Get Evaluated by a Physical Therapist

The vast majority of back pain is not caused by a serious medical issue. However there are some very rare cases where this can be true, which is why it is important to have your back evaluated in order to help rule out a more serious problem. Once that is ruled out, a physical therapist can help get you back to moving better and getting you back to comfortably doing the things you love to do.


KEEP MOVING

The best treatment for lower back pain is to keep moving! It is recommended to get back to your normal daily activities as quickly as possible. Numerous different types of exercise have been shown to be beneficial including strength training, walking, biking, yoga, and Pilates. Finding a particular exercise that feels good and that you enjoy is really beneficial for your back in the long run, along with the other countless health benefits that come with exercising. I often say that the best type of exercise you can do for your back is the one that you enjoy and will do consistently(5). A physical therapist can be very helpful in getting you into an exercise routine that best suits your unique needs and goals!



References:

1. Gilbert FJ, Grant A, Maureen, et al. Low Back Pain: Influence of Early MR Imaging or CT on Treatment and Outcome—Multicenter Randomized Trial. Radiology. 2004;231(2):343-351. doi:https://doi.org/10.1148/radiol.2312030886


2.Pengel LHM, Herbert RD, Maher CG, Refshauge KM. Acute low back pain: systematic review of its prognosis. BMJ : British Medical Journal. 2003;327(7410):323. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC169642/


3.St. Sauver JL, Warner DO, Yawn BP, et al. Why Patients Visit Their Doctors: Assessing the Most Prevalent Conditions in a Defined American Population. Mayo Clinic Proceedings. 2013;88(1):56-67. doi:https://doi.org/10.1016/j.mayocp.2012.08.020


4.Stubbs B, Koyanagi A, Thompson T, et al. The epidemiology of back pain and its relationship with depression, psychosis, anxiety, sleep disturbances, and stress sensitivity: Data from 43 low- and middle-income countries. General hospital psychiatry. 2016;43:63-70. doi:https://doi.org/10.1016/j.genhosppsych.2016.09.008

5.van Middelkoop M, Rubinstein SM, Verhagen AP, Ostelo RW, Koes BW, van Tulder MW. Exercise therapy for chronic nonspecific low-back pain. Best Practice & Research Clinical Rheumatology. 2010;24(2):193-204. doi:https://doi.org/10.1016/j.berh.2010.01.002







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