Back pain is so prevalent that it
costs the country more than cancer and diabetes treatment combined, but there
are many myths circulating about the condition. We asked some of Ireland's
leading experts to shed some light on the common ailment.
Scientific research in the area
of back pain has progressed in recent times and it is challenging widespread
beliefs held about the condition that seems to plague so many people.
1 Back Pain is common and normal
Eighty percent of people will
experience an episode of back pain during their lifetime. Experiencing back
pain is like getting tired or becoming sad; we don't necessarily like it, but
it occurs to almost everybody at some point. What isn't common, however, is not
recovering from back pain.
Most acute back pain is the
result of simple strains or sprains and the prognosis is excellent. Within the
first two weeks of an acute episode of pain, most people will report a
significant improvement in their symptoms with almost 85pc of people fully
recovered by three months. Only a very small number of people develop
long-standing, disabling problems.
2 Scans are rarely needed
Both healthcare professionals and
members of the public often consider getting a scan "just in case"
there is something serious involved in their pain. However, all the evidence
suggests scans only show something truly important in a tiny minority (<5pc)
of people with back pain.
A brief consultation with a
healthcare professional (eg GP, chartered physiotherapist) would usually be
able to identify if a scan was really needed based on a person's symptoms and
medical history.
3 Interpreting scans should come with a health warning
We used to think that if we got a
good enough picture of the spine with scans that it would be a big help in
solving back pain. However, we now know that this is most often not the case.
When people have scans for back
pain, the scans often show up things that are poorly linked with pain. In fact,
studies have shown that even people who don't have back pain have things like
bulging discs (52pc of people), degenerated or black discs (90pc), herniated
discs (28pc) and 'arthritic' changes visible (38pc).
Remember, these people do NOT
have pain! Unfortunately, people with back pain are often told that these
things indicate their back is damaged, and this can lead to further fear,
distress and avoidance of activity. The fact is that many of these things
reported on scans are more like baldness - an indication of ageing and genetics
that do not have to be painful.
4 Back pain is not caused by something being out of place
There is no evidence that back
pain is caused by a bone or joint in the back being out of place, or your
pelvis being out of alignment. For most people with back pain, scans do not
show any evidence of discs, bones or joints being 'out of place'.
In the very small number of
people with some change in their spinal alignment, this does not appear to be
strongly related to back pain.
Of course, it is worth noting
that many people feel better after undergoing treatments like manipulation.
However, this improvement is due
to short-term reductions in pain, muscle tone/tension and fear, NOT due to
realigning of body structures.
5 Bed rest is not helpful
In the first few days after the initial
injury, avoiding aggravating activities may help to relieve pain, similar to
pain in any other part of the body, such as a sprained ankle. However, there is
very strong evidence that keeping active and returning to all usual activities
gradually, including work and hobbies, is important in aiding recovery.
In contrast, prolonged bed rest
is unhelpful, and is associated with higher levels of pain, greater disability,
poorer recovery and longer absence from work. In fact, it appears that the
longer a person stays in bed because of back pain, the worse the pain becomes.
6 More back pain does not mean more back damage
This may seem strange, but we now
know that more pain does not always mean more damage. Ultimately, two
individuals with the same injury can feel different amounts of pain. The degree
of pain felt can vary according to a number of factors, including the situation
in which the pain occurs, previous pain experiences, your mood, fears, fitness,
stress levels and coping style. For example, an athlete or soldier may not
experience much pain after injury until later when they are in a less intense
environment.
Furthermore, our nervous system
has the ability to regulate how much pain a person feels at any given time. If
a person has back pain it might be that their nervous system has become
hypersensitive and is causing the person to experience pain, even though the
initial strain or sprain has healed.
This can mean the person feels
more pain when they move or try to do something, even though they are not
damaging their spine.
Once people with back pain can
distinguish between the 'hurt' they are feeling from any concerns about 'harm'
being done to their back, it is easier to participate in treatment.
7 Surgery is rarely needed
Only a tiny proportion of people
with back pain require surgery. Most people with back pain can manage it by
staying active, developing a better understanding about what pain means, and
identifying the factors which are involved in their pain.
This should help them continue
their usual daily tasks, without having to resort to surgery.
On average, the results for
spinal surgery are no better in the medium and long-term than non-surgical
interventions, such as exercise.
8 Schoolbags are safe - worrying about schoolbags might not be
Many people believe that children
carrying a heavy schoolbag might cause back pain. However, research studies
have not found this link, revealing no differences in schoolbag weight between
those children who do and do not go on to develop back pain. However, if a
child - or their parent - believes that their schoolbag is too heavy, the child
IS more likely to develop back pain, highlighting the importance of fear in the
development of back pain.
Given concerns about inactivity
and obesity in children, carrying a schoolbag may actually be a simple healthy
way for children to get some exercise.
9 The perfect sitting posture may not exist
Should we all sit up straight?
Contrary to popular belief, no specific static sitting posture has been shown
to prevent or reduce back pain. Different sitting postures suit different
people, with some people reporting more pain from sitting straight, others from
slouching. So while slouching gets a bad press, there is no scientific evidence
to support this. In fact, many people with back pain can adopt very rigid
postures (eg sitting extremely upright) with little variation.
The ability to vary our posture,
instead of maintaining the same posture, together with learning to move in a
confident, relaxed and variable manner is important for people with back pain.
10 Lifting and bending are safe
People with back pain often
believe that activities such as lifting, bending and twisting are dangerous and
should be avoided. However, contrary to common belief, the research to date has
not supported a consistent association between any of these factors and back
pain.
Of course, a person can strain
their back if they lift something awkwardly or lifting something that is
heavier than they would usually lift. Similarly, if a person has back pain,
these activities might be more sore than usual. This, however, does not mean
that the activity is dangerous or should be avoided.
While a lifting or bending
incident could initially give a person back pain, bending and lifting is normal
and should be practiced to help strengthen the back, similar to returning to
running and sport after spraining an ankle.
11 Avoiding activities and moving carefully does not help in the
long-term
It is common, especially during
the first few days of back pain, that your movement can be significantly
altered. This is similar to limping after spraining your ankle, and generally
resolves as the pain settles. While initially hard, getting back doing valued
activities which are painful, or feared, is important. Many people, after an
episode of back pain, can begin to move differently due to a fear of pain or a
belief that the activity is dangerous. Such altered movement can be unhealthy
in the long term and can actually increase the strain on your back.
12 Poor sleep influences back pain
When someone has pain, a good
night's sleep can be hard to get. However, it works both ways as sleep problems
can lead to back pain in the future. In the same way that poor sleep can make
us more stressed, give us a headache, make us tired or feel down, it can also
cause or prolong back pain. So, improving sleeping routine and habits can be
very helpful in reducing pain.
13 Stress, low mood and worry influence back pain
How we feel can influence the
amount of pain we feel. Back pain can be triggered following changes in life
stress, mood or anxiety levels.
In the same way that these
factors are linked to other health conditions like cold sores, irritable bowel
syndrome and tiredness, they have a very large effect on back pain. As a
result, managing our stress, mood and anxiety levels through doing things we
enjoy, and engaging in relaxation can be really beneficial in helping back
pain.
14 Exercise is good and safe
Many people with pain are afraid
of exercise and avoid it as they think it may cause them more problems. However
this is not true! We now know that regular exercise helps to keep you and your
body fit and healthy, and actually reduces pain and discomfort. It relaxes
muscle tension, helps mood and strengthens the immune system once started
gradually.
All types of exercise are good,
with no major differences in effectiveness between them - so pick one you
enjoy, can afford and which is convenient.
Walking, using the stairs,
cycling, jogging, running and stretching are all good and help relax all the
tense muscles in your body.
When you are in pain, starting
exercise can be very hard. Under-used muscles feel more pain that healthy
muscles. Therefore, if feeling sore after exercise, this does not indicate harm
or damage to the body.
15 Persistent back pain CAN get better
Since back pain is associated
with many factors that vary between individuals, treatments that address the
relevant factors for each individual can be effective. Failing to get pain
relief after lots of different treatments is very frustrating and cause people
to lose hope.
However, this is very common as
most treatments only address one factor, for example someone goes for a massage
for their sore muscles, but doesn't address their sleep or fitness or stress
levels.
By identifying the different
contributing factors for each individual and trying to address them, pain can
be significantly reduced and people can live a happier and healthier life.
Back Pain Treatment
Back pain treatment involves to identifying the root cause
of the back pain and then targeting the treatment towards it. Injections,
medications, and other passive therapies can help temporarily in providing pain
relief, but they cannot stimulate the healing process. Exercise in a
controlled, gradual, and progressive manner is the only way to stimulate the
healing process.
A customized treatment plan is made focused on the
individuals goals. Back pain treatment involves education about the correct
posture and work ergonomics, specific controlled movements, device based
therapy, spinal mobilizations. Treatment is focused on correcting the
inefficient muscles and achieving the planned functional goals .An active
lifestyle and regular controlled movements is the key towards preventing
reoccurrence of back pain.
Accelerated Spinal Muscle Regeneration is an established
and proven treatment methodology delivered by spine specialists through the use
of unique medical protocols and advanced technology. Our
initial detailed assessment and diagnostic procedure (DSA) identifies the
specific deficiencies in muscular strength and flexibility which in-turn cause
pain. This medical report provides the basis for a customized treatment program
(ASMR), where the identified muscle groups are targeted and isolated through
the use of advanced technology to accelerate their regeneration.
Qi Spine Clinic
are back pain treatment specialist in Mumbai, Delhi and Pune. Successfully
treated 19,000 patients with 91% success rate in treating Back Pain in
Pregnancy and Acute Low back Pain.
Clinic Locations: Currently we have 19 clinics across India in Mumbai, Delhi & Pune
Contact Us: +91 8655885566/ +91 7827907070
To learn more, please visit qispineclinic.com