Some (inconvenient) Truths About Backs

Back pain can be debilitating, limiting and above all scary. However, this doesn’t mean that we should become completely reliant on our chosen healthcare professional…

Some facts:

– 80% of the population will suffer back pain at some point. 85% of these cases will not have any specific cause. (Ref 1)
– Your back is extremely STRONG and ROBUST, and is designed to cope with bending and lifting.
– Segments of you back DO NOT go in and out of place and DO NOT need realigning over a long running, costly series of treatments.
Core (in)Stability IS NOT a reliable predictor (or cause) of back pain. (Ref 2)
– Scans are rarely needed, and are only PART of the bigger picture. Discs age, they can bulge, they sometimes herniate, but they never slip. Research shows time and time again that the % of “abnormal” findings on Lumbar Spine (lower back) in MRI & CT images in PAIN FREE subjects in 30-40 year olds shows 40% had Disc Bulge. Pain is NOT THE SAME as damage. (Ref 3)
– Nearly all of us have worn joints – it is a NATURAL caressing of time. Worn joints do not correlate with painful joints.
– Pain relies on CONTEXT; social, psychological, biomechanical. Fear and apprehension can be as harmful as the physical condition. Nocebic, fear-mongering, harmful language by therapists can contribute to this.

However –

– None of these mean that your recovery can not be AIDED, and sped up. But none of them point towards treatments lasting months, or longer. Often long-term treatment plans go hand in hand with harmful, nocebic words, either intentionally or unintentionally.
– Treatment alone, without patient input and education, can cause over-reliance on the therapist, and lack of SELF-MANAGEMENT.

The National Institute for Health and Care Excellence (NICE) provides national guidance and advice to improve health and social care. Their advice for Non-specific low back pain and sciatica management” includes (Ref 4);

Do;

  • Consider a group exercise programme for people with a specific episode or flare-up of non-specific low back pain with or without sciatica. Take people’s specific needs, preferences and capabilities into account when choosing the type of exercise.
  • Consider manipulation, mobilisation or soft tissue techniques (for example, massage) for managing non-specific low back pain with or without sciatica, but only as part of multi-modal treatment packages.
  • Consider a combined physical and psychological programme (preferably in a group context, that takes into account a person’s specific needs and capabilities) for people with persistent non-specific low back pain

As importantly, the recommended do not’s include; belts or corsets, foot orthotics, traction, acupuncture, ultrasound, routinely offered opioids, or spinal injections for managing non-specific low back pain and sciatica.

So try not to panic when your back “goes” – it will “come back”, and you shouldn’t be left bankrupt because of it. As always, if you are in doubt, seek professional advice.

DOWNLOAD MY FREE E-BOOK, A 34 PAGE GUIDE TO WHAT PAIN IS, HOW IT WORKS, AND WHAT YOU CAN DO ABOUT IT!

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N.B. There are no ‘one size fits all’ style quick fixes in most injury scenarios, so these article shouldn’t be seen as such. They are merely guides to a better understanding of how our bodies work.

For more information please visit www.dc-injuryclinic.co.uk

REFERENCES

  1. Deyo & Weinstein, 2001
  2. http://www.ncbi.nlm.nih.gov/pubmed/18187614
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4464797/
  4. https://www.nice.org.uk/guidance/ng59/documents/short-version-of-draft-guideline

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