Part One of a Three Part Series
I see back pain on a regular basis, actually closer to a daily basis, and I see everything from acute low back pain, SI joint pain, to chronic low back pain and more. I’m sure that if you’re reading this either you or your closest friend, co-worker, or a family member has had it before. In fact, one in four people experiences back pain in their life.
And… approximately $86 billion health care dollars are spent on low back pain each year. Next to a common cold, this is what people seek medical attention for.
With that said, I think it’s really important to classify acute versus chronic pain, discuss the current course of low back pain in America, why imaging is most likely not necessary, and how back pain can be managed effectively
How Low Back Pain is Managed in America
Let’s discuss a typical course of low back pain in America. You bend down to pick something up and have excruciating pain. You go to your primary care doctor. They will give you a pain medication, or a muscle relaxer. You leave the doctor’s office, take the medication as prescribed and then the pain does not go away. You still have low back pain so then you go back to the doctor and the doctor says “I’m going to refer you to a specialist, a spine doctor.”
So then you go to a doctor, you get ordered an X-ray first because an X-ray always typically comes before an MRI. You get an X-ray which shows absolutely nothing except that you may have degeneration. Because the X-ray doesn’t show anything, you get an MRI. So of course the insurance bills are racking up because you’re going through all these doctor’s appointments, imaging, and medications. Then you get the MRI. And guess what? It shows that you have a bulging disc, herniated disc, or degeneration… or ALL of it! You freak out, and you don’t know what to do. “Do I go to PT or do I go to a chiropractor or do I need to get surgery?” You’re going through all this chaos and everyone’s telling you to do different things, and you stop moving, you stop doing what you normally do, and you’re fearful to do anything.
You don’t exercise because you’re afraid to move because the fear sets in. And then after that, you may decide that you figure out a course of treatment. But at that point, you’ve wasted so much time—anywhere from a month to up to six months or even more of trying to go through this process and totally shifting from what was an acute low back pain episode to now what is considered chronic low back pain.
Acute Low Back Pain
Acute low back pain is when you bend over to pick something up, often light, and you have sharp pain that can take your breath away or even drop you to the floor. Now, it doesn’t mean it always has to be this severe. Often times I hear, “I was just picking up a pencil and I felt excruciating low back pain.” Back pain can also be associated with sitting way too much, lifting or carrying things with poor mechanics and repetitive motions.
But, again, what happens often during that time is that you get fearful to move and your autonomic nervous system always wants to feel safe. Safety and stability go hand in hand, always wants to feel safe. So as you begin to have more fear of movement, then your nervous system is not safe, and then you do not stabilize as well. So every time you go into this protective mechanism of “I’m afraid to move, bend, or twist,” you are making things worse!
Therefore, my first piece of advice is to make sure that if you have an acute episode of low back pain, that you continue to move. I say this all the time! And move as normally as you can. No resting, constantly lying down, sitting. You need to MOVE! You want to move because you want your nervous system to say, “okay, no big deal.” It was just pain which is a warning signal (information). It’s your yellow light. And yes, something was wrong. Something wasn’t moving correctly in the body and you had a pain signal, but it WILL go away. If you continue to go back to your normal course of life, that is.
Stay tuned for the part two of three… How can you treat your acute low back pain ? and part three… What is chronic pain and what can you do about it?
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