Pain in the back is normal
Submitted by Curtis Mason DPT
More than 80 percent of people will experience back pain in their lifetime. Put into perspective, that means more people are likely to have back pain than to reach retirement. Back pain should be considered a normal occurrence.
With something this normal there should be a consistent treatment to alleviate the symptoms and return normal function. However, this is not the case and low back pain is one of the leading causes of long term disability, loss of work, decline in economic status, and increasing medical costs.
In 2005 the United States spent $32 billion dollars on visits to doctors’ offices, clinics, surgery, and prescription medication for back pain. People with back pain have 60 percent higher medical expenditures than people seeking medical attention without back pain. This problem has also increased in cost significantly in the last 10 years.
Part of the difficulty with back pain is that it does not follow the standard medical model. Let me give an example. With the medical model you have a problem (i.e. bacterial infection) and go to the doctor who diagnoses the problem (strep throat), you are then are given medication to treat the infection, the infection is cured and you move on with life.
On the other hand, with back pain only about 15 percent have a specific diagnosis and these typically have something to do with a fracture or surgery. Otherwise the diagnosis is normally “low back pain” or “lumbago.” This is almost the equivalent of diagnosing someone with “sick” or “heart problems.” Without having a specific diagnosis, giving a specific treatment then becomes very difficult.
This is why back pain treatment has been so inconsistent and with such poor results in the past.
In an effort to try to identify the problem more MRIs and x-rays have been ordered. These have not been shown to identify the cause of pain in that same 85 percent who do not have a fracture or previous surgery.
Herniated disks on MRI are as common in people WITHOUT back pain as they are in people with back pain. An x-ray on someone who is 70 years old will show degenerative joint disease almost 100 percent of the time with or without pain. The results are similar in almost every low back diagnosis using x-ray or MRI. In other words a herniated disk might or might not cause pain. This also explains why back surgery has mixed results. In fact, research shows that if you get an MRI you are 3 times more likely to have back surgery.
There is hope in new research aimed a treatment based on presentation instead of diagnosis. For example, if you have back pain less than 16 days and the pain does not go below your knee you have a 92 percent chance relief within 2 visits with manipulation, with greater results when stabilization exercises are taught over another 3 visits. This can be achieved by a physical therapist who manipulates the spine or with a chiropractor who teaches stabilization.
Other studies are being done to identify the most effective treatments for different presentations. In fact, if you have been suffering from back pain it might be time to seek out a medical professional and finally get relief.
Curtis Mason is a doctor of physical therapy and the owner of Elite Physical Therapy and Health and the Elite Health Club located at 1316 Oakley Ave, Burley, ID 83318 and can be reached at 678-2155. www.MyEliteBod.com
