By Loni Rodriguez, PT
We know that many people do. It is actually one of the leading causes of disability world-wide. Did you know that at any given time, about 540 million people are experiencing low back pain? This is one of the most COMMON areas of pain! It also has dramatically increased healthcare costs and how many people use their healthcare dollars to treat it. Back pain is costing YOU more money than it needs to.
I want you to understand the fears that surround low back pain and help you understand it. It is important to talk about this stuff! Helping you understand these fears is vital to creating a positive outcome for both short term and long term pain.
I have put together the most common fears that surround this topic. It is important to understand that these fears are real, many people have similar beliefs, and the way that these fears are handled is very important. If you have some of these thoughts or beliefs, please be open to the explanations, ask questions, and make your own assumptions based on what you read.
There are also many other medical and fitness professionals out there who have different viewpoints. Please understand that this is my viewpoint backed by the most recent understanding of what science knows about low back pain. I learn the up-to-date stuff because I just want to be a bit less wrong, versus being right. The hope is that I can help you learn HOW to view low back pain and not WHAT to view about it.
Additionally, this is NOT supposed to be a guide to help your exact situation. Please seek the help of a trusted professional to deal with your individual case of low back pain. It can be used as a guide to help you understand back pain a bit more versus directing your treatment.
- Definition… What is low back pain? We can define low back pain as a symptom and not a condition. A symptom is well known to come and go, a condition feels like it is there to stay.
- Vulnerability… You may view your lower back as being vulnerable and needing protection. When back pain is experienced, you may view it as though your back has lost that protection. Many people experience lower back pain after trivial events and view the pain as damage, now needing protection. The feeling of vulnerability is real! You feel this way because first off, the back pain happened after something so simple as bending over to move a dog bowl. Second, you now think there is damage. Your back is not vulnerable and you do not need to worry that it will fail on you, even if you feel that has happened in the past. If you have been diagnosed with degeneration or arthritis, you do not have to feel fragile and that vulnerability will slowly fade as you become more and more confident. Your back is built to last, treat it with what it was born to take.
- Protection… You may feel that you have to protect your back if you have had a painful experience, leaving you feeling fragile. Back pain has been thought to be a result of lost protection. Now we know, however, that protection is not the key. Whether it means avoiding certain things because you do not want to have back pain, or keeping yourself out of certain activities because you fear your back pain will worsen. Both scenarios could actually be prolonging the issue. You get the permission to move! We want to add movement into your normal routine, little by little. It is like building up a retirement account, adding money in little by little builds to a solid chunk of change. Adding confidence to your low back over time creates long-lasting resiliency.
- Uniqueness… You may view back pain as being very special in nature, very different or unique from other forms of pain experiences in regards to how it impacts you. Back pain seems incredibly complex because it’s severe and you don’t know much about your back or its structures. Low back pain is viewed differently than other types of pain, but it shouldn’t be. It is commonly seen as special and its own entity, however it needs to be viewed under a different light. Back pain is just like pain in any other area of the body and it is not a warning sign for the spine. It does not mean you must stop doing the activity and it sure as hell does not mean that you are damaging anything.
- Damage… Pain means damage, damage needs healing, best to rest? Pain is commonly viewed as damage in the lower back, or anywhere in general. We now know that there can be a ton of pain and no damage, or a ton of damage and no pain. The correlation is just not there. Pain and damage do not go hand in hand and we do not need to be worried that increasing pain means further damage.
- MRI scans… MRI to the rescue? Many people seek to get MRI scans done to help direct treatment, identify worsening conditions, or rule out anything serious. We must rethink our views on medical testing (MRI’s, X-ray’s). Many of the findings are normal and just a part of the aging process and can be considered the grey hair of the spine. Most conditions such as arthritis, degeneration, or disc herniations do not cause pain. If MRI’s were the only ways to identify gray hair, would you want and MRI? So why would you want one? The most important reason to get an MRI would be to rule out the very serious conditions such as fractures, infections, cancer or tumors. Those conditions are extremely rare and found in about 3% of cases of low back pain. There are also very specific questions that could lead us to believe that one of those cases could be an issue. If those answers don’t fit, then the likelihood of you having any those conditions is extremely low. Not many doctors follow this protocol because they aren’t trusting in the new direction of medicine and reimbursement is pretty high for MRI’s and X-rays.
- You and your back need to be friends… You need a positive relationship with your lower back. It can feel like your back pain rules your life, and you have become a different person as it consumes you. Before you know it, you begin to notice that your back pain has made you a real bear. Your spouse, kids, and co-workers know when you are in a fight with your spine. Well, the reality is that it does not have to be like that and you have to trust that your back won’t fight back if you begin to make it do its job.
- Back pain, personified… A mind of its own. Your back pain does not have to rule you or your life. Personification of low back pain is common and understandable, but it does not truly have a mind of its own. You don’t have to walk on eggshells around it or tread lightly. Poke the bear with activities that slightly make it angry. Over time, you will notice that the amount of activity you can handle will sky rocket and you will once again be in control.
- Understand the uncertainty… It is hard to tell what someone’s outcome will be, but we know that it will get better. The outcome of low back pain is commonly unknown. The healing process is hard to see, especially because you aren’t really sure what is damaged or what needs to heal. The truth is that in most cases, nothing needs to heal and we always fall back on the fact that pain does not mean there is damage. Trying to search for the root cause will be a never ending battle and it is always multifactorial in nature. There is a ton of misinformation out there and you have to remember that. In general, you must understand that most cases of low back pain get better. If you are someone who has had back pain for years, there is TONS of hope. There are likely some underlying factors that have yet to be revealed.
Thank you for reading. This topic weighs heavily in my passion to pave the road of pain relief for many suffering from both short-term and long-term pain. I am determined to help you understand more about what is going on inside your body and empower you, versus scare you. You must remember that all cases of low back pain are different and treatment and education is extremely individualized. If you are suffering from low back pain and have yet to seek medical attention, please DO NOT use this editorial as a treatment guide. Please ask for help or find a trusted professional to guide you in the best direction.
That’s all folks…