Back pain is so common that it affects 80% of Americans in their lifetime. However, even with such a high prevalence, many continue to have inaccurate beliefs (“thought viruses”) about back pain and how to go about fixing it. In fact, many things you try to help back pain or actually negatively affecting it. On that note, here are a few simple pointers to fix your back pain and prevent recurrences!
Start doing something for it sooner than later
Often times we are told wait for the pain to go away. However, the sooner you start to see a medical professional the faster the results can be. Usually the prognosis is pretty high (85+%) for a full relief. As a therapist who seems patients with direct access, back pain can typically get under control within 1-2 sessions! So seek a therapist out after 7-10 days of back pain.
Start taking an active approach
Utilizing treatments such as heat, ice and ultrasound, can bring improvement, but their effect are usually temporary. Mounting evidence continues to prove that taking an active approach to your recovery, including exercise and postural correctives, lead to faster recoveries.
In contrast, prolonged bed rest is unhelpful, and is associated with higher levels of pain, disability, poorer recovery and longer absence from work and return to your fitness pursuits. In fact, it appears to have strong correlation between the length a person stays in bed because of back pain, and the severity and length of the pain.
Start lifting properly (but don't stop lifting!)
Poor lifting mechanics can put excessive load on the soft tissue structures. Find a movement specialist who can retrain your mechanics to ensure adequate load on the back and begin the process of building confidence and durability for lifting.
While initiating lifting can be scary, getting back to your prior level of function and fitness is important. Many people, after an episode of back pain, begin to move differently due to a fear of pain or a belief that the activity is dangerous. These altered movement can be unhealthy in the long term and can actually alter muscle activation and coordination, leading to movement compensations and guarding and thus longer episodes of pain.
Start finding movements that are good for you
While bending forward may have initiated the back pain, don’t assume other movement will be harmful. Often times the back has a “directional preference” after a back incident that helps calm the muscles and soft tissue down and allows for rapid pain relief. Additionally, movement is key to acute tissue healing as this inhibits guarding mechanics and gives feedback to the body that other painful movements can follow suit. Movement regains strength, increases circulation and healing, and restores confidence in your back. Physical Therapists specializing in movement can find the best movements to calm your back down.
Start exercising
Similar to moving, the return to a gradual exercise program will be helpful for back relief. Although potentially scary at first, exercise reduces back pain. Find a therapist that can help you with this process and pick the right exercises, intensity, and progression for you.
Often times people want to fix the back pain without fixing the common cause of the pain: poor and/or sustained sitting postures. Adding positives won't always work if we don't eliminate the negatives! Apply simple strategies, like limit sitting to 30 minute periods when at work, (as well as other helpful tips) to eliminate back pain all together.
STOP caring about the Diagnosis and Imaging
This one might be the most important of them all. 85% of back pain is “nonspecific” and can be fixed with the above corrections. “Nonspecific” also meaning it's not a single abnormal entity at the root of your pain. Don't get caught up in “L5 herniations” or “stenosis”. You are more than a static xray or MRI that has no real connection to your pain. Your pain is mechanical, meaning it's influenced by movement. Don't let a test that doesn't assess movement tell you what's wrong with you!
Imaging of your back often show things that are poorly correlated and have NO connection to your pain. In fact, studies have shown that even people who don't have back pain they still present with things like bulging discs (52%), degenerated discs (90%), herniated discs (28%) and 'arthritic' changes visible (38%).
Remember, these people do NOT have pain! Unfortunately, people with back pain are often told that these things indicate their back is damaged, and this can lead to further fear, distress and avoidance of activity. The fact is that many of these things reported on scans are more like wrinkles - an indication of normal aging and not an actual sign of pain generators.
The main benefit that a skilled therapist provides is the ability to test and re-test your symptoms following an intervention. Our interventions are very efficient at alleviating pain but they do not magically abolish or fix a degenerated disc. However when movement and pain improves one can rest assure that the degenerative changes were not the cause of the pain the whole time!
