Experts estimate that 80% of Americans will experience low back pain during their lifetime. In the last three months, 25% of Americans have had low back pain. Low back pain can have many causes but the most common causes are musculoskeletal. Good news is that means conservative treatments often work! I am also a believer that a good rehabilitation program will not only help your back pain now, but help you avoid future back pain as well. No, you do not have to live with a “bad back” forever. Here are a few other things I wish everyone would know.
You are not your MRI.
I have had many patients that come to PT who have had an MRI or other imaging. Sometimes the MRI is from 10 years ago, sometimes it is recent. Either way, I still perform a full evaluation which includes movement testing, flexibility, muscle and core strength, joint mobility, and more. It also includes looking at the pelvis, hip, lumbar spine, and any other surrounding structures that may be contributing to pain. An MRI does not show stiffness, weakness, or how someone moves.
Just because imaging shows something is “wrong”, it does not mean that is the source of pain. A research study took imaging of people without back pain. They found disc bulges in 30% of 20 year olds, 60% of 50 year olds, and 84% of 80 year olds. This means that you can have a disc bulge with NO pain. Yes, disc issues can cause pain, especially initially but our bodies can heal. More research has found spontaneous regression (where the disc shrinks/heals) in 96% of disc sequestration, 70% of extrusion, 41% of protrusion, and 13% of bulges. This means that the further out the disc is protruding, the better chance it has of healing on its own. Pretty amazing, right? Our bodies are designed to heal.
Imaging may be important if there was a traumatic injury (like falling off a ladder), or if there are signs of significant neurological involvements (such as leg weakness, coordination loss or bowel/bladder changes like sudden incontinence/loss of control). But other than that, save your time and money, and start with Physical Therapy.
When low back pain starts, a common response is to try to protect yourself. For many people, this leads to not moving that area or trying to lay down and rest more. Unfortunately, this can lead to stiffness and muscle weakness. It is important to keep moving. Avoid certain movements that cause pain, but usually that does mean you need to avoid everything.
Look at the big picture.
I often joke with my patients that I am treating the “leftovers”, especially when they are coming to Physical Therapy after dealing with low back pain for months or years. When we are in pain, our bodies compensate. Muscles often tighten up to protect us but this can also lead to muscle weakness and imbalances or different movement patterns such as limping or not putting as much weight on one leg. Unfortunately, when the pain subsides our bodies do not automatically reset. We need to consciously strengthen and retrain our bodies, which is possible but may need some guidance.
Research has also shown an association between chronic back pain and pelvic floor dysfunction in women. 90% of women with chronic low back pain had pelvic floor dysfunction, with 80% of them having incontinence (leaking urine). So ladies, if you are leaking urine (yes, even a little bit), having pelvic pain or pressure, or pain with intercourse- you should seek help. Not only can it help resolve your issue but it may help with back pain, hip pain or another issue.
Also keep in mind that stress levels, nutrition, and sleep can all contribute to our ability to heal. When our sympathetic nervous system is in charge, our body is in “fight or flight” mode and more easily overreacts to stimuli. This can cause more pain and impairs healing. We want our parasympathetic nervous system to kick in which is “rest and restore” mode. Deep breathing and meditation exercises are helpful to start calming down the nervous system and facilitating the healing process.
If you want more guidance, get our free guide, 7 tips to help your Back Pain. And if you or a loved one is suffering from back pain, schedule a free virtual discovery session with an expert Physical Therapist to determine if PT is the next best step for you. And the best time to take action is now!
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Just click on the picture: 7 Tips to help your back pain feel better without pain medication, injections, or surgery or Post-baby Body Basics: what every Woman needs to know about their postpartum body.