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 debilitating and disabling. It prevents you from spending time with loved ones or simply 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?”.
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.
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. Acute pain is generally related to an accident or injury and there is a specific incident that can generally be recognized as the cause of the pain. Some cases of acute pain do last longer than a few days which is why pain is only labeled as chronic after it has been present for a few months.
Another type of low back pain is “mechanical pain”. Mechanical pain is a general term that is used 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.
So how do you know what 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 difference to their recovery. Guidelines recommend that doctors reassure patients that 90% of back pain patients get better within 6 weeks. Unless there are red flags present, treatment is generally conservative and patients are advised to keep moving and take over the counter pain relievers if necessary.
New research is wondering 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 putting it somewhere between 2% and others as high as 56%.
Factors Affecting Recovery
A 12 month study of almost 1000 patients in Sydney, Australia, found that only ‘72% of participants had completely recovered 12 months after the baseline consultation’. While 83% of study participants had returned to work by 3 months, 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.
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
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 (the patient’s mental health and their environment) was a key factor in predicting poor outcomes. Psychological factors related to depression, or the patient’s belief that they were not going to get better soon, was directly tied to how slowly (or quickly) they recovered.
Biopsychosocial Treatment Model
A review of 25 different studies also confirmed that psychological factors 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) have a major role to play in low back pain recovery. This is often referred to as a ‘biopsychosocial model’ for pain and recovery.
So this brings us back to our initial question of, "Will my back pain heal itself?"
Unfortunately it appears that the answer to this question is 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 are in the situation where your back pain hasn’t gotten better after a week or so, you may find yourself looking for 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. There are programs that you can do in the comfort of your own home and that are highly convenient, no matter what your schedule looks like.
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. Therapies such as 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. Firstly it helps with circulation of blood and nutrients to your muscles, keeping them healthy. Secondly, it helps 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
A positive mindset and having someone reassure you that you can, and will, get better is so important to your recovery process. As the studies showed, 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.
While unfortunately there isn't 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, but you can do some key things to help yourself heal faster. By doing some of the things we listed above you will have a much better chance of getting back to your regular lifestyle and activity levels from before your injury.
With a bit of luck your low back pain will be more acute and will go away fairly quickly, but if it isn’t we really hope that you don’t feel like you are alone or that you 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.