Myth No 1: "Complete rest is the best treatment”
The old treatment system of bed-rest for low back pain has been utterly rejected in recent years in favor of the “motion is lotion” belief which is that returning to gentle exercise and movement as soon as possible is a better approach for quicker pain relief and reduction of recurrence. It stands to reason surely that a stronger back will give less trouble which is why the more active approach is preferable.
Myth No 2: “Low back pain should be treated with medication.”
The treatment of back pain symptoms with medication is not the most modern and scientific approach anymore. While reducing pain, this is not a long term solution for a low back pain patient either with a chronic or acute history of low back pain. More important are figuring out the root cause of the issue and changing the causative patterns with an appropriate strengthening or stretching programme. Sometimes both approaches simultaneously are advantageous but medication solely as a treatment almost always assures recurrence.
Myth No 3: “Scans are required for diagnosis”
The reality of having x-rays or MRIs or CT scans performed is that there are very often incidental findings which may or may not be the actual cause of this specific episode of low back pain but in either case will rule the treatment plan. Often-times it is better to treat the body and re-align any anomalies and then re-assess the pain pattern to decide if a scan is actually necessary.
Myth No 4: “Back pain is rare”
Recent research is saying that in fact 80-90% of the population of the world suffer back pain during their lifetime with on an acute or chronic basis.
Causes of Low back pain are wide-ranging. Here are a few of the common types:
1. Facet joint pain-caused by degenerative changes, acute strain or abnormal spinal loading.
2. Intervertebral disc-Trauma or degeneration to an intervertebral disc can cause rupture of the Annulus pulposis (outer protective ring) resulting in a bulging of the nucleus pulposus ( more liquid shock absorbing centre). This can result in varying levels of pain and referring symptoms. If this sounds familiar please also read our PB blog on Sciatica).
3. Muscle issue: This is referring to either an acute muscle strain in the area of the lumbar spine or a weakness of the “core” muscles which are the stabilizers of the lumbar spine. Sometimes the “acute strain” may even be cause by the lack of strength of this “stabilising” deep set of muscles (consisting of the transverses abdomens anteriorly and multifidus posteriorly amongst many others).
As you can see from the above there are many causes of LBP and even these anatomical causes can be more complex and result from more chronic issues which may or may not be known to the sufferer for example flexibility issues or imbalances of strength or postural issues. For this reason at PB our approach to low back pain is multi-faceted. We pride ourselves on our holistic treatment plans. Our assessments may include looking at things like pelvic alignment, leg length discrepancies and even foot alignment. Please do not be concerned if we do not start treatment by working on your low back where the pain is focused. We are merely assessing your body to figure out the actual root cause of your problem. We may have to look at your seated posture and we will for sure question you on your activity level and what types of activity you perform on a regular basis.
Of course we will ask you about your perceived cause of pain, but we often find that the real cause is deeper-rooted and more complex. In almost all cases you will be given a short program of “homework” which may consist of stretches, strengthening exercises, postural adjustments or even changes of footwear. We have found that this approach, as well as a continued level of “smart” exercise for your body type are the best way to not only treat the acute condition but also to prevent recurrence.
In short don’t expect your “run of the mill” assessment of current symptoms at PB, instead come prepared for a detailed assessment and “detective” session and for a personalized strategy towards your recovery.
“Do the best you can do until you know better. Then when you know better, do better” -Maya Angelou