Back pain is one of the top reasons that people visit their doctor and it is a leading cause of disability around the world. It can come on suddenly or it can sneak up on you over time.
No matter what type of back pain you have, it can be devastatingly debilitating and deceptively disabling. Back pain prevents you from spending time with loved ones and stops you going about your day to day activities.
It is no wonder then that the most common questions about back pain are, “Will my back pain heal itself?” and “How long will I take to recover?”. In this blog we take a look at whether back pain can heal itself, if it needs medical attention, and what sort of recovery times people can expect from the healing process.
Acute Vs Chronic Pain
There are two main types of pain associated with low back problems - acute pain and chronic pain. Acute low back pain is the most common type of low back pain and it generally lasts between a few days to a few weeks. Chronic low back pain is classified as low back pain that has lasted for longer than 3 months.
The experts at the Cleveland Clinic distinguish the two from each other in terms of how quickly the pain goes away as well as if it lingers even when the injury has been treated.
If your back pain is acute then there is a good chance that it will resolve on its own within a few days and you will be back to your usual activities in no time. When you have acute low back pain you can often trace it back to some accident or injury even if it wasn't a major one - they rarely are when it comes to low back pain!
In some instances, acute low back pain can last longer than a few days (or weeks) which is why pain is only labeled as chronic after it has been present for a few months.
Mechanical Pain
Another type of low back pain is called “mechanical pain”. Mechanical pain is often used as a general term to refer to any time of back pain that occurs when an unusual amount of stress or strain is placed on the muscles that support your spine.
Things like poor posture, picking things up incorrectly, and repeated strenuous movements can lead to mechanical pain. Mechanical pain can last anywhere from 4-6 weeks since strains and sprains of the muscles can take a little longer to heal.
Some common (but also serious) causes of mechanical pain include:
vertebral fractures
So how do you know what type of pain you have and what factors influence your body’s ability to heal itself? How long do you give it before you intervene?
Current Guidelines On Recovery
Studies have shown that the type of advice that low back pain patients receive from their doctors can make a major difference to their recovery.
International Guidelines recommend that doctors reassure their patients by sharing the comforting information that around 90% of back pain patients get better within 6 weeks of injury. Education is key!
Unless there are red flags present, treatment should generally be conservative and patients are advised to keep moving and take over the counter pain relievers if necessary.
New research has come to light recently that makes us wonder if those statements might be a little too optimistic? While many low back pain sufferers do recover fairly quickly, the risk of developing chronic low back pain is uncertain, with some estimates placing it somewhere between 2% and others as high as 56%.
Risk Factors Affecting Recovery
A 12 month study of almost 1000 patients in Sydney, Australia, found that a mere ‘72% of participants had completely recovered 12 months after the baseline consultation’. While 83% of study participants had officially returned to work by 3 months, things like disability and pain took much longer to resolve.
So what factors impacted their recovery? The authors of the study found 7 things that played a role in how quickly people recovered from their low back pain.
Older age
Compensation
Higher pain intensity
Longer duration of pain before consultation
More days of reduced activity due to low back pain
Feelings of depression
Perceived risk of persistence
The Importance Of Following The Guidelines
A 2021 study published in the JAMA also looked at the transition from acute to chronic low back pain. This study looked at more than 5000 patients from 77 different healthcare clinics.
What was interesting about this study was that it looked at how many patients got non-guideline-based treatment recommendations from their doctor within 21 days of their injury! It wasn't a big surprise that the more non-recommended treatments people got, the more likely they were to move from acute to chronic low back pain.
Psychosocial Factors Affecting Low Back Pain Recovery
The researchers discovered that recovery from low back pain was not as fast as the guidelines seemed to indicate. They found the recovery process to be typically slow and not always complete. These results occurred even when the doctors were providing the best practice care in line with clinical guidelines.
The researchers also found that psychosocial factors (things like the patient’s mental health and their environment) was a key factor in predicting poor outcomes. Psychological factors related to depression, or even the patient’s belief that they were not going to get better soon, was directly tied to how slowly (or how quickly) they recovered.
Biopsychosocial Approach To Pain
When it comes to pain management researchers are starting to take a slightly different approach to care, This approach is often referred to as the "biopsychosocial model" and it takes the view that people who suffer from complex chronic pain conditions (like low back pain) need a more holistic approach to managing their condition.
This biopsychosocial approach to pain management considers patients to be more than just the symptoms of their pain. It recognizes that things like what we eat, where we live, and how we feel emotionally can all play a role in our experience and perception of pain.
Psychological Factors Affecting Back Pain Recovery
A review of 25 different studies confirmed that psychological factors do indeed play a major role in predicting how long people will take to recover from low back pain.
The authors of that review found that psychological factors like stress, depression and somatization (the physical expression of stress by our bodies) did indeed play a major role to play in how people recovered from low back pain.
Will My Back Pain Heal Itself?
So this brings us back to our initial (and very important) question of, "Will my back pain heal itself?"
Unfortunately it appears that the answer to this question is quite a complicated one. While many cases of back pain do seem to get better on their own, studies indicate that this number may be over-exaggerated.
If you find yourself in a situation where your back pain hasn’t gotten better after a week or so, you may need to start looking for some ways to help speed up the recovery process.
Ways To Speed Up Your Low Back Pain Recovery
1. Don't Wait Too Long Before Getting Help
Research shows that the longer the pain goes on before you get help, the worse the outcomes are. Many people suffer on their own, relying on ineffective over the counter medications to mask the pain instead of getting to the root of the pain and actually fixing things.
When it comes to treating non-cancerous pain, unfortunately pain medications are only effective about 30% of the time.
Guidelines highly recommend treatments like physical therapy and exercise to help the healing process. Companies like Hinge Health, Sword Health, and LivaFortis now offer programs that you can do from the comfort of your own home so you don't even have to go to a clinic. These programs are highly convenient and flexible so it doesn't matter how crazy your schedule is.
2. Manage your stress levels
We can see from the research that stress has a negative effect on how quickly our bodies can heal. Stress, anxiety and depression have all been found to increase our perception and experience of pain.
Therapeutic interventions like mindfulness, meditation, deep breathing, or cognitive behavioral therapy have all been proved to help reduce lower back pain and speed up the recovery process.
3. Keep Moving
Exercise is one of the best things that you can do for your low back pain. It may seem like the exact opposite of what you think you should be doing (or what you feel like you should be doing) but exercise helps in many ways.
First off, exercise helps to improve your circulation sending important blood and nutrients to your muscles, keeping them healthy.
Secondly, exercise helps to generate endorphins which are your body’s “feel good” hormones and that can help reduce your sensitivity to pain.
Thirdly, it keeps your muscles supple and flexible and helps prevent them from stiffening and being prone to further injury.
4. Believe That You Will Get Better
It may sound silly or overly simplistic but a positive mindset and having someone reassure you that you can, and will, get better is actually a very important part of the recovery process.
Studies have shown that when people felt like they were never going to get better it had a negative effect on their recovery. Getting help with your recovery process can take the form of a great physical therapist, a health coach, a therapist, or even a digital physical therapy program that has all of those in one can be a game changer to your recovery time.
Conclusions
While unfortunately there isn't really anything you can do about your age or the compensation process you may have to go through if your back pain is related to an accident or injury, hopefully you have read about some simple things that are in your control when it comes to healing from low back pain. By doing some of the things we have listed above you should have a much better chance of getting back to your regular lifestyle and your pre-injury activity levels.
With a bit of luck your low back pain will be more on the acute side and will clear up fairly quickly, If for some reason it doesn't go away it is important to know that you aren't alone and you don't have to suffer in silence. The sooner you get help and can start working on treatments that are proven to work for low back pain, the faster you can get back to living pain free and doing all the things you love again.