Back Facts!
The internet is full of so much wonderful information, unfortunately, when it comes to back pain advice there is a lot of misinformation. We created this post to try and combat some of this. While this is not an exhaustive list, it provides a good place to start in helping understand back pain.
Acute Back Pain
Acute back pain or back pain that came on recently can often be very painful and quite scary. The good news is that most episodes of acute back pain are not caused by a significant injury to your back, and we are able to heal from most of these pains. Some important things to do when you have an episode of acute low back pain:
First, we need to rule out any of the more severe causes of back pain. Thankfully, these are very rare but it is important to have an assessment done by a healthcare provider such as a chiropractor, physiotherapist or physician. If you have any bowel/bladder changes, or numbness in the genitals it is important to go to the emergency room as this can be a sign of something more serious.
Second, try to remain active within your tolerance. We used to advise bed rest to patients, but staying active is much more beneficial for your recovery. Exercise and activity will likely play a key role in your recovery. If you are able to carry on with your daily activities such as going to work this has also been shown to help aid recovery.
Third, we have a couple of options for treatments for acute low back pain to supplement staying active. Seeing a chiropractor, physiotherapist, massage therapist or acupuncturist can all be good options. Each person’s back pain experience is unique and may benefit from different treatments. The use of superficial heat also seems to provide relief for some patients.
Chronic Back Pain
Chronic or persistent low back pain is defined as back pain that has lasted greater than 3 months. Chronic low back pain can often be frustrating for both patients and clinicians as it is often unpredictable, less responsive to treatment and long lasting. Here are a couple of things to keep in mind with chronic low back pain:
For the majority of patients in chronic pain, it is safe for you to move and this can often be helpful. One thing to keep in mind though is that you want to start small and build up to more activity as you can tolerate it. Walking or swimming can be great places to start.
Chronic pain often involves your nervous system being extra sensitive to things that otherwise shouldn’t be causing pain. This sensitivity can be made worse by things such as stress, anxiety or depression. Addressing some of these other factors can often be key to improving chronic pain.
The longer that pain persists, the more the focus should be on active treatments that the patients work on themselves rather than passive treatments where something is “done” to the patient.
Imaging for Back Pain
X-ray, MRI, Ultrasound, CT Scan. ”Do I need imaging? Which one of these will show me what is going on in my back?” This is a question that we get all the time from our patients. Lets go over this:
The good news is that the vast majority of patients with back pain will not require imaging! This may come as a surprise, but most types of back pain actually don’t show up very well on imaging. This can be frustrating for patients, but imaging is designed to show us significant structural problems, and the good news is that most back pain is not caused by any of these. Of course there are expectations to this, and if you have previous imaging it is always helpful to bring it in for us to review.
Prevention of Back Pain
How can I prevent my back from getting hurt in the first place? This is a question we get asked everyday at the clinic, and unfortunately, there is no perfect answer. Prevention of back pain is challenging and much of the data suggests that most people will experience a few episodes of back pain throughout their lifespan. There are however a few things that you can do to try and help prevent back pain.
Stay active – Activity levels, or more accurately, how sedentary you are seems to have an effect on back pain recurrence. Something as simple as increasing how much you walk each day can help decrease the rates of back pain, but staying active with any activity you enjoy is helpful.
Education – Learning about your back from a qualified healthcare provider has a protective effect. Back pain can often be scary and this fear may exacerbate the problem but having reassurance and education from a healthcare provider helps.
Smoking – Patients who smoke have higher rates of back pain. If you smoke, try and work on quitting and if you don’t smoke, don’t start.
Maintain a healthy weight – In addition to many other health benefits, maintaining a healthy weight seems to offer some protection to the back.
Prevention is challenging and we still have a lot to learn but these are a few good places to start.
Myths About Back Pain
Everybody seems to have their own opinion, or something they have heard about back pain, let alone what you can find if you search it on google. Here we are going to go over a few common myths
Joints going in, or out of place/getting misaligned.
One thing to keep in mind is that all of the bones and joints in our spine are held in place by many very strong ligaments and muscles. In the absence of major trauma, our joints stay where they should be. Older practitioners may use this “joint out of place” language, but as we learn more about the spine we now know this is not the case.
Deadlifts are bad for your back
There is nothing inherently dangerous about the deadlift movement. In fact, our backs were designed to bend and twist and move in all different directions. Where we can get into trouble with deadlifts (and all strength training for that matter) is if we do too much too soon and overload the tissues. This can lead to an injury which may have been avoided with proper progressive loading.
Sitting up straight will prevent back pain
The more we study posture and how it relates to pain, the data is pointing us to the idea that there is no perfect posture and that regular movement throughout the day seems to be more beneficial. Of course there are exceptions to this, but we don’t need to be as worried about sitting with perfect posture as we once were.
We hope this has been helpful. As always, if you have more questions about your back feel free to discuss this with your healthcare provider.
