Tuesday, June 23, 2009

The Back Pain Epidemic

Did you know hat Americans spend at least $50 billion each year on low back pain? Did you know low back pain is the most common cause of job-related disability and a leading contributor to missed work? And the only neurological ailment more common in the United States than low back pain is headache.

Most incidences of low back pain are temporary and the result of trauma to the low back from sports, overuse with housework/yard work, or a motor vehicle accident. This usually results in inflammation and muscle spasm in the low back, creating a problem that is mechanical in nature. There are situations, however, where the source of pain is a damaged structure like a protruding disk, a fractured vertebrae, or a pinched nerve. In these cases, it's very important that you seek the advice of a physical medicine and rehab physician or a spine specialist for the next step in caring for your back.
Finding The Right Balance
In treating many patients with mechanical low back pain (and even some of those with structural issues), I have found that there is usually an imbalance in hip flexibility, thoracic mobility, and core strength. In other words, most of my patients have tight hip/leg muscles, they are very stiff in the thoracic spine (usually from poor sitting posture), and have weak abdominal and back muscles due to deconditioning. Most of the time, correcting these imbalances will provide a significant reduction in pain and improvement in function.

For example, I had the opportunity to treat a crew athlete that had been diagnosed with several disc protrusions in his low back. One physician told him that he would never be able to row again. Another doctor said, "Who knows how many of these crew athletes have protrusions. They sit in that prolonged position in the boat for practice and competition. If we did an MRI on all the crew athletes, we might find some with the same thing. But how many of them are actually in pain? Go ahead and treat the imbalances first and see what happens."

Well, that's what we did. This crew athlete had very poor hamstring flexibility and core strength. We worked very hard on this for 8 weeks and he started to see improvements in both of these areas. Soon after, guess what: His Back Pain Decreased!!! And before he knew it, he was back in the boat with the crew team rowing!!

Treat The Cause, Not The Symptoms
Fortunately for the crew athlete, his second doctor was able to think outside the box, or should I say the back. (A very good doctor might I add. If you would like more information about him, email me at jchun@espt-ca.com). This is something that we are seeing more and more as medicine (and physical therapy) is evolving. Just because someone has back pain, you don't just keep treating the back. This can provide relief, but without addressing some of the other issues mentioned above, the back pain will likely return.

Most physical therapists use modalities like ultrasound, electrical stimulation, cold lasers, and traction to address low back pain. But that should not be the only thing they do. If it is, you need to find yourself another therapist. Those things will only address your pain. A physical therapist that looks at the whole person and not just the diagnosis, will help patients find the root cause of their back issues. They will help patients find balance in their bodies. Balance between flexibility, mobility, and strength, so that the low back pain is relief is for longer periods and the occurrences are fewer and farther between.
For more information about how physical therapy can help decrease low back pain or for a comprehensive evaluation, contact us at Elite Sports Physical Therapy at (510) 656-3777.

Next blog post........Simple Stretches and Exercises for Low Back Pain.

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