Got Back Pain?

Got Back Pain?

Back pain.

If you are a living, breathing human being, you have either experienced back pain yourself or known someone who has.  This post is part 1 of a series discussing this common issue.

Back pain is the #1 cause of job related disability in the United States.  Some studies estimate that Americans spend $50+ billion yearly to treat back pain1.  A 2006 study in the Journal of Bone and Joint Surgery estimated between $33 to $66 billion was spent directly treating back pain2.  An OSHA study from 1990 estimated indirect costs (time missed from work) for back pain and other musculoskeletal problems to be $45 billion per year2.  Adjusted to 2017, that would be a total of $124 billion to $164 billion spent yearly in today’s dollars.

In fact, a quick Google search for “back pain” produces 34,800,000 results.  What is the every-day person supposed to do with all the information and advice about back pain?  Undoubtedly some of it is good, while others are outdated, and still more are bizarre at best.  In my 25 years as a physical therapist, I have found one thing to be universally true:  Fear increases pain.  And the best way to overcome fear is knowledge.

Often when people experience significant back pain, their first concern is that they have “blown” or “slipped” a disc, or worse yet, have a tumor.  Combined, these and other serious causes account for less than 15% of people with low back pain.3  Regardless of the cause, low back pain can be quite debilitating, resulting in time lost at work, home, and recreation activities.

Low back pain can have many causes including:

  • Strained (pulled) muscle from an injury, posture, or poor lifting
  • Sprains of spinal joints
  • Joint dysfunction or abnormalities like scoliosis, arthritis, etc.
  • Disc issues like degeneration (shrinking), herniation (bulging), or tears
  • Occasionally from referral from an internal organ

The good news is that over 50% of episodes of low back pain resolve without medical treatment within 2-6 weeks.  There are, however, times when you should seek medical attention.4-7

A physical therapist, physician, osteopath, or chiropractor should be consulted with the following symptoms:

  • Pain that has not resolved (or at least steadily improving) in 4-6 weeks with self-treatment
  • Pain that is worsening with self-treatment
  • Pain prevents you from sleeping or makes it very difficult to move
  • Pain radiating into one of both legs, especially if it goes past the knee
  • Numbness or weakness in one or both legs
  • History of an injury that could have caused a fracture (broken bone) and you have not gotten x-rays
  • Recurring back pain

If back pain is accompanied by the following, a physician or osteopath should be consulted:

  • Decreased bowel, bladder, or sexual function
  • Nausea, vomiting, abdominal pain
  • History of osteoporosis or cancer
  • Unexplained weight loss

Now that you know when to seek medical help, it is helpful to know what basic self-treatment looks like.

  • For a known, recent injury like after lifting heavy objects, falls, or accidents, an application of ice to the area for 15-20 minutes is still recommended for the first 48-72 hours. You can re-apply the ice every hour if needed.
  • For back pain without known “injury” or that is more than 72 hours old, ice or heat may be used. When using heat, apply for 20-30 minutes.
  • Avoid bedrest! The old recommendation of 1-2 weeks of rest has been shown not to be beneficial, and in many cases, aggravates the symptoms.  Brief periods of rest between bouts of activity can help.
  • Keep moving.
  • Topical treatments like Biofreeze, Ben-Gay, etc. can reduce the pain although they do not “treat” anything.

 

**While this post includes basic medical information about back pain, it is not intended to diagnose or prescribe specific treatment for individuals.  If you have a history of serious medical problems, questions, or other concerns, consult an appropriate medical professional.**

In my second post, I will share simple exercises you can try for back pain.


References:

  1. http://www.moneycrashers.com/costs-back-pain-treatment-prevention/
  2. https://spine.osu.edu/indirect-costs-back-pain-and-msds
  3. https://www.uptodate.com/contents/low-back-pain-in-adults-beyond-the-basics
  4. http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/neurology/low-back-pain/
  5. http://www.prospirapaincare.com/lower-back-pain-treatment-without-surgery-7-conservative-options-that-may-work-for-you/
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1495170/
  7. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet

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