Low back pain. It’s one of the most common conditions affecting people worldwide. It causes missed work days, visits to the doctor, lots of unnecessary MRIs and x-rays, and can be a lifelong condition that people just cannot get to the bottom of.
Expensive Diagnostics - Are They Worth It For Back Pain?
In 2014, researcher AL Schwartz and his colleagues reported that annual Medicare spending on imaging for uncomplicated low back pain was estimated to range anywhere from $82 million to $226 million. This enormous figure did not even include the costs associated with follow-up testing and care.
Because regular x-rays are not sensitive enough to detect spinal pathologies, healthcare providers are turning to magnetic resonance imaging (MRI) and computerized tomography scans (CT scans) to try and find the underlying cause of lower back pain.
MRIs can be useful to detect deterioration of the spine but research has shown that deterioration of the spine often has little to no impact on low back pain. In other words, the pain is happening independent of the degeneration and the two are not linked.
Does Research Support Getting An MRI For My Back Pain?
A study conducted by Barbara S. Webster and colleagues was published in the Journal of Occupational Medicine in 2010. In this study, Webster’s research found that there were no real indications for having an MRI in most cases of low back pain.
What's more, the results of their study suggested that the “effects of early MRI are worse disability and increased medical costs unrelated to the severity of the condition".
It comes as little surprise then, that guidelines do not recommend the use of imaging for most cases of low back pain, finding that they can often do more harm than good. So, if we don’t know what causes low back pain, how can we fix it?
When Does Low Back Pain Occur?
Fortunately, most cases of low back pain will revolve on their own, usually with minimal interventions. But for an unlucky few, back pain issues can come back to haunt you - and usually at the most inconvenient time.
Low back pain often shows up in your 20s and can continue throughout adulthood, often tapering off as we get older, when it then becomes due to things like osteoarthritis or degenerative disc disease.
Preventing Back Pain
When it comes to managing low back pain, prevention is key!
There are so many products and medications available to back pain sufferers, but unfortunately many of them are aimed at temporary pain relief rather than getting to the root causes or trying to prevent low back pain issues from happening in the first place.
One way to prevent low back pain from occurring is to understand what activities can trigger it.
Common Causes Of Low Back Pain
Improper lifting of heavy items
Repetitive twisting of your body
Certain physically demanding jobs (Factory work, police officers, hairdressers)
Sedentary jobs (sitting at a desk all day, or driving cars, trucks, or cabs)
How To Prevent Low Back Pain
Knowing that your occupation might be putting you at a higher risk for low back pain can help make you more aware of things that you can do to combat this risk. Just because you are a police officer or a dentist and on your feet all day, doesn’t mean that you are doomed to suffer from low back pain.
There are several things that you can do to prevent low back pain as well as getting low back pain relief if it is something you already suffer from. The following techniques are great ways to get it and how to keep it.
How To Get Relief From Low Back Pain
When we get injured one of the first things we are told to do is rest the injured body part. Interestingly enough, research has found that, when it comes to low back pain, the opposite advice applies.
International guidelines actually recommend that you avoid bed rest, stay active (although doing it gently is best), and keep moving to prevent stiffness and immobility from setting in.
Ice and Heat Packs
Heat or ice packs are an easy and effective way to manage low back pain. These treatments together can help to reduce stiffness, swelling, and pain. You don’t have to use anything fancy, although there are lots of affordable products available on the market.
A simple hot water bottle or heating pad generates heat to reduce pain and stiffness, while an ice pack can help reduce swelling and pain. You might want to try switching between heat and cold. Use heat for 15 to 20 minutes, then a few hours later use ice for 10 to 15 minutes.
Physical therapy is a guideline-recommended, first line treatment for low back pain. This type of treatment can help address the movement and functioning of your muscles and joints.
Specialized exercises and supportive therapies can help reduce low back pain and help to restore function, getting you moving again. Home exercise programs and digital physical therapy clinics also help patients continue with stretching and strengthening exercises to help reduce the risk of another injury at a later stage.
When it comes to managing low back pain you don’t have to do anything too strenuous in order to reap the therapeutic benefits of exercise. Yoga, Pilates, Tai Chi, walking, and swimming are some of the best, low impact exercises for low back pain relief. And there is even data to support some of these exercises.
In 2016 a systematic review study was conducted by Hui-Ting Lin, PT PHD and colleagues was published in the Journal Of Physical Therapy Science.
The results of the study found that in patients with chronic low back pain, Pilates showed significant improvement in pain relief and functional enhancement. Exercise does not have to be intensive or painful, just consistent and it helps to build strong core muscles to help support your spine.
Massage therapy is an excellent treatment for low back pain. Massage therapy helps to improve the blood circulation which, in turn, helps sore muscles recover from strenuous activity or injuries.
Massage therapy also relaxes the muscles, helping to make them more supple and mobile, and improving muscle range of motion. When the correct muscles are targeted patients often experience pain relief.
We all sit far too much each day, and when we are sitting, many of us do not have the best posture. Poor posture can lead to back and neck problems. When you are slouching in your seat, or slumping when standing, you put pressure on the wrong parts of your back and spine.
Slumping and slouching can cause your back and core muscles to become strained, reducing the supply of blood to these muscles, and making them stiff and weak. All of this contributes to low back pain.
Taking frequent breaks from sitting, using posture trainers and ergonomically supportive chairs can all make a significant difference to your back.
Biofeedback has been around since the 1920s but its use has remained largely clinical and research- based due to the expensive nature of biofeedback devices and the scientific knowledge required to both administer and interpret the data received.
Biofeedback relates to the ability to gather information from the body and using that information to learn new ways of managing pain. A 2019 study found that biofeedback treatment “led to an improvement in well-being, depressive mood and pain-related disability”.
As new products bring this technology to patients in more accessible and affordable forms, more clinical studies are being conducted to help reassure insurance companies about the effectiveness of this treatment in managing and preventing chronic low back pain.
Chiropractors are licensed doctors that specialize in working with the spine. Through a treatment called ‘spinal adjustment’ chiropractors help improve alignment, reduce pain, and restore mobility to the spine and joints.
Research has shown that this type of treatment is effective in relieving pain associated with low back conditions and it is a much safer option that medication or surgery.
Stress can play a major role in how we experience low back pain. Stress can cause inflammation in our muscles and can cause our muscles to feel tense and make them more prone to injury.
Talk therapy, including a specific type of therapy known as ‘cognitive behavioral therapy’ (CBT) can both relieve stress and help to manage how we experience chronic pain.
If it sounds a little strange that therapy can help with an injury, check out some of the many trials that have been done on this type of intervention.
Researchers have found that CBT, and a type of therapy called mindfulness-based stress reduction (MBSR), alleviated chronic low back pain in adults. One study published in Journal Spine in 2008 reported that CBT is an effective component in treating chronic low back pain.
Low back pain can be highly debilitating and it can feel like you can’t go anywhere or do anything without being in pain all the time.
While it can be challenging to treat low back pain due to the fact that we often can’t see any specific causes through imaging and x-rays, it doesn’t mean that there aren’t scientifically proven therapies to help manage and prevent low back pain.
All of the treatments that we have listed in this article are proven therapies with research behind them, making them more attractive options for people than trying the latest fads and gadgets that are advertised on TV.
With a little help you can manage your low back pain and keep it from taking over your life with these techniques, but they do require a little work.
Whatever type of treatment you decide to use, make sure you use some sort of measurement tool to track your progress so you can see the difference that it is making.
Free tools like the Oswestry Disability Index can help you track your progress and see how far you have really come. Many of these treatments will take a little time to work, but the results should be longer lasting and have few to no side effects.