Around 1 in 6 Australians suffer with back pain each year (Australian Institute of Health & Welfare, 2017). Socialising, working or doing the things that you love may become demanding due to back pain which can in turn have a big impact on life; retiring early, loss of independence and a feeling of confinement. This is avoidable!! And changing thinking around misconceptions of back pain can be a starting point.
- Persistent back pain can get better. Scans are not routinely requested because often imaging results do not change management strategies
- Back pain is rarely caused by something being out of place, spines do not “crumble” and discs do not “slip”
- Bed rest is not helpful; it can cause stiffness of joints, muscle shortening and general deconditioning alongside building a fear of pain associated with moving and exercising
- Surgery is rarely needed and is not a quick fix. For example, there is more and more research surfacing to show that surgical treatment does not provide faster relief from back pain symptoms in patients with lumbar disc herniation at a long-term follow up when compared with patients managed in physiotherapy (Gugliotta et al, 2016; Jacobs et al, 2011; Lequin et al, 2012).
- Stress, low mood, worry and poor sleep influence back pain. Learning about what pain means and where it comes from can help with management – ask your physiotherapist to explain pain science to you
- Belts, corsets, orthotics and many other gadgets should not be routinely used
- Traction is not routinely offered as an effective treatment. Manual therapy may be used as a part of a treatment plan including exercise and education
- Continuing to go to work with modified duties and a return to full duties plan is helpful
- A “quick fix” is usually not possible and a long-term management plan is more effective
- Spines are strong structures and can manage bending, lifting and daily stresses
- A back reactivation programme may include strengthening, stretching, conditioning of the entire body and an education component. This is important to build a strong and stable body however it can take a long time to gain strength and condition, so it should be persevered with for at least 6 weeks. It should also be progressive and you may feel muscle soreness after exercising
How can I help my back pain?
- Staying active – find something that you enjoy doing on a regular basis. Discuss with your physiotherapist how to integrate back into your hobbies
- Aiming to avoid relying on medication, scans and surgery unless all other options have been tried – exercise programmes take time to work so give it time to take effect
- Sleeping, relaxing and looking after yourself – try mind maps including things that empower you and lifestyle factors which you feel may contribute to back pain. Devise strategies to increase activities which empower you and decrease activities which hinder you . You can discuss this with your physiotherapist
- Create short-term goals with a timeframe in mind to increase activity step-by-step which contribute towards a bigger end goal
- Developing a better understanding about what pain means – pain is often associated with damage however this is not necessarily the case. Pain is produced by the brain so it can persist after tissues have healed. Your physiotherapist can explain this to you in further detail
- Developing thinking strategies – the pain and anxiety areas of the brain sit closely and signals can become mixed meaning anxiety may cause more pain which may cause more anxiety and so a vicious cycle is entered . Psychological therapy can be effective in the treatment of back pain as a part of a treatment plan
- Varying posture and moving in a confident and relaxed way – the spine is designed to move so bracing due to pain is not helpful.
- Do not fear bending and lifting – the spine is a strong and stable structure, lift in a way that makes you feel comfortable. Repetitive heavy lifting should be 50:50; half squatting and half bending. Avoiding these manoeuvres may even weaken the back. If the load is more than you can manage, seek help from somebody else
- You should seek medical attention if you have acute back pain with progressive leg weakness or abdominal pain
- Seek advice from a physiotherapist for information specifically tailored to your back pain, to help you to integrate back into your daily activities as quickly as possible and to learn back reactivation exercises to reduce frequency of reoccurrence as early as possible
Blog by Lauren Palmer (Physiotherapist)