Why Am I Having This Debilitating Low Back Pain?
The point of this blog post is to help people make better decisions about their care. Low back pain is very common and can sometimes feel debilitating. The reader of this blog is encouraged to read the sources and make a decision for themselves regarding the care they elect to have. At Movement Minded we are here to empower our patients.
It’s very common to wake up with low back pain. If you’re reading this article you have probably stumbled out of bed, had difficulty standing up straight and those first few steps are painful, brushing your teeth isn’t a picnic either. You brace movements by holding your breath, and get dressed really slowly. We know, we help people like you every day.
Its estimated that 80% of the population will experience a back problem at some time in their lives (1), and 50% of all working Americans admit to having back pain symptoms each year (2). One would think with such a common condition treatments would be well defined, unfortunately low back pain, especially if it happens spontaneously is usually difficult to treat with conventional methods like heat, ice, Ibuprofen, etc because its a combination of several chronic causes.
Generally when patients walk into our office with low back pain we perform a thorough exam. First we have to rule out that its not something more serious like referred pain from an organ, or something more sinister. Its rare but it does happen. We will usually refer you to a medical doctor or get you to an urgent care center.
Some signs and symptoms are:
- Sudden change in bowel and bladder
- Tingling, weakness, or loss of feeling in leg
- Inability to walk
If all of the above are ruled out, we can start considering other causes like:
- Degenerative disc disease (DDD)
- Herniated Disks
The above causes can be questionable , and research has consistently shown that herniated discs and DDD are inconsistent with people. Thats not to say that they don’t exist, we have treated many people with DDD, and herniated discs successfully but some of the more common causes of low back pain that we see are:
- Breathing restrictions
- Musculoskeletal imbalances
- Biomechanics influences
- Muscle spasms
- Nerve restrictions
What about MRI’s? Shouldn’t I get an MRI or an X-Ray?
Magnetic resonance imaging or MRI’s are not helpful for recovery of low back pain. A recently published article comparing patients who recieved an MRI first vs physiotherapy, the patients who got the MRI first spent on average $4,793 more with similar outcomes of both groups (3). If we are not making any progress with our sessions we will refer you to someone who can get you an MRI ASAP.
Over the counter NSAIDs like Ibuprofen
Sometimes they work, sometimes they don’t. A recent study showed that only one in six people taking NSAID pills for back pain experienced meaningful reduction in their symptoms compared to people who took placebo. The people who took the NSAIDs also were 2.5 times more likely than those who didn’t to report gastrointestinal problems including stomach ulcers and bleeding (5).
How can movement help my back pain?
There is a growing amount of research on low back pain. The one thing that has consistently shown to make progress is movement. Bed rest for longer than one day can really slow down your recovery (4). So try to stay as active as you can, if the pain doesn’t get better in a day schedule an appointment. We are always happy to help.
“Bed rest for longer than one day can really slow down your recovery.”
We continue our exam checking how you breath, how you manage your mass, is there more weight on your left foot or right, can you fire your core reflexively, hows that ribcage looking? We look at all of these thing to identify the root cause. The “combination of several chronic causes” I mentioned above may be the fact that you spend a majority of the time your standing on your right foot. That may be the reason that the right side of your low back is spasming. Gettin relief from low back pain may seem difficult. Getting to the root cause of it is our top priority, we also educate our patients along the way so they understand whats going on.
1. Rubin Dl. Epidemiology and Risk Factors for Spine Pain. Neurol Clin. 2007; May;25(2):353-71.
2. Vallfors B. Acute, Subacute and Chronic Low Back Pain: Clinical Symptoms, Absenteeism and Working Environment. Scan J Rehab Med Suppl 1985; 11: 1-98.
3. Fritz JM, Brennan GP, Hunter SJ. Physical Therapy or Advanced Imaging as First Management Strategy Following a New Consultation for Low Back Pain in Primary Care: Associations with Future Health Care Utilization and Charges.
4. Advice to rest in bed versus advice to stay active for acute low-back pain and sciatica. Cochrane Database Syst Rev. 2010 Jun 16;(6):CD007612. doi: 10.1002/14651858.CD007612.pub2.
5. .Gustavo C Machado, Chris G Maher, Paulo H Ferreira, Richard O Day, Marina B Pinheiro, Manuela L Ferreira.Non-steroidal anti-inflammatory drugs for spinal pain: a systematic review and meta-analysis. Ann Rheum Dis annrheumdis-2016-210597, doi: 10.1136/annrheumdis-2016-210597.