Have you ever been limited by low back pain? You’re not alone. 88% of Americans will experience low back pain at least once in their life to a degree that their normal, daily function is limited. Americans miss about 264 million days of work per year due to low back pain and spend $50 billion dollars each year to treat it pharmaceutically. Surgically, only 1.2% of people will ever receive a procedure for low back pain, but low back pain-related surgeries compose 30% of all healthcare costs!
So, if low back pain affects almost everyone and we spend a ton of money trying to treat it, what actually causes low back pain? When we have a bad episode of low back pain, we tend to catastrophize about what is going on. Is it a disc? A broken bone? Something more sinister, like cancer? We have great news: 94% of all low back pain cases are musculoskeletal in nature, meaning that at some point in time, a demand was asked of the low back muscles that were greater than their capacity. A longitudinal study followed patients from 1979 – 2015 (36 years of life), searching for variables related to the likelihood of encountering low back pain, and found that overwhelmingly, individuals with the highest levels of muscular endurance AND cardiovascular endurance were the least likely to develop low back pain (Aasa et al., Spine, 2015). There is not a more sinister, underlying disease process occurring: almost all episodes of low back pain are simply a diagnosis of “back not strong enough disease.”
Knowing now that almost all instances of low back pain are a case of “too much, too soon”, what is the best course of treatment? Overwhelming evidence, including physician clinical practice guidelines, recommends manual therapy like spinal manipulation (“adjustments”) or dry needling in combination with exercise-based therapy (Oliveira et al., European Spine Journal, 2018). We like to simplify this at HealthHQ with the phrase “Crack and clang”. The most effective treatment for low back pain is to use hands-on techniques to reduce pain & improve motion while using active exercise to reinforce & load the movements that previously aggravated your low back pain. Several high-quality research studies have correlated increasing levels of low back strength & endurance with reduced pain, improved motion, and increased confidence with movement & exercise (Holmberg et al., Advances in Physiotherapy, 2012; Welch et al., BMJ, 2015; Berglund et al., JSCR, 2015; Aasa et al., JOSPT, 2015; Tagliaferri et al., JSCR, 2020).
Back pain can be frustrating and even feel defeating at times, but it does not have to be that way. Working with a physical therapist to find out which specific motions or activities aggravated your pain while finding other motions that alleviate your pain can quickly silence your pain, allowing you to begin to strengthen the muscles of the low back to reduce the likelihood that pain returns in the future. Instead of seeking out X-rays, MRIs, pills, and surgery, consider bulletproofing your lower back for a longer-term fix.
Tired of low back pain? Stuck in a cycle of “on again/off again” back pain? Give us a call or text at 810-354-5380 or book an appointment at https://healthhq.fit/schedule/
Back pain 101
