What Doctors Don’t Tell You About Back Pain

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Back pain is a national and international epidemic.

An estimated one billion people across the globe suffer from it every day. In fact, chronic back pain has become the number two reason people seek medical care and is the number one cause of disability.

We don’t think back pain should be something that you have to live with. We see hundreds of cases of back pain that often get better with simple advice and treatment.

So what are doctors not telling you about your back pain? What is it that is stopping you from getting better, pain-free and living life to its fullest?

These are all the reasons why your back pain is still there:

The doctor sends you for an MRI or X-ray.

MRI Scans and X-rays rarely help to identify the true cause of back pain.

The biggest cause for concern for patients is often the fear that they have slipped a disc or pinched a nerve. These injuries are often associated with recommendations for invasive procedures such as surgery or a lifetime of suffering. When MRI’s came out in the 80’s they thought that we had the technology to identify back pain as we could see changes in people’s backs more clearly, especially the discs of the spine. We jumped to conclusions and associated these changes on the MRI’s with the patient’s back pain.

But what we didn’t realise was that healthy people often have these changes in the spine and they do not have any back pain at all.

In fact, many people over the age of 30 have signs of a disc bulge on MRI and they don’t have back pain. We know now that most cases of disc bulges are like wrinkles – they are a natural part of ageing but don’t cause us pain.

In 90-95% of cases, MRI scans and X-rays do not show us the true cause of back pain.

Only in less than 1% of cases are MRI’s or X-rays of any value to you or your doctor in determining your cause of back pain. If you have been diagnosed as having a disc bulge/prolapse/herniation, arthritis, spondylitis, or wear and tear based on your MRI or X-ray alone, you need to see an experienced and up-to-date back expert who can accurately diagnose your condition. Imagine trying to work out why your car engine was not working by taking a photograph. There is no chance they could tell what was wrong with it.

You can’t diagnose what is causing back pain by taking fancy photos either.

You are given medication to fix your back pain.

In the short term anti-inflammatories and painkillers help to reduce pain so you can move better and heal. Simple over the counter medications are often all that is needed for most cases of back pain. They probably have their peak effect after 2-3 days and up to 7 days, but beyond that, they do more harm than good.

The stronger the medication the more likely you are to have more serious side effects, which can include an increase in pain. Dependency on codeine-based painkillers is a significant problem.

“Consumers frequently became addicted to codeine,” a TGA statement said. “Misuse of OTC [over-the-counter] codeine products contributes to severe health outcomes including liver damage, stomach ulceration, respiratory depression and death.” Long term use of medication is not going to fix your back pain – ever.

Pain is a signal from your brain to take action. You can’t cover up the pain with drugs and expect the cause of your back pain to go away. You have to find out the real cause for your back pain, and in many cases, there is a simple fix, as long as you are in the hands of a back pain practitioner with experience in resolving back pain.

You are told that surgery will fix your back pain.

Unless you have a serious disease process like cancer or a fracture of the spine, or you can’t feel one or both of your legs, surgery is more than likely not the answer.

We know that the scans that surgeons use don’t reliably detect the cause of your back pain. So if it’s not the true cause of your back pain you should leave it alone.

The body is a complex interaction of body parts. You can’t just go and cut out an important part like a disc and expect the body to be better afterwards. Strengthening your gluteal (buttock) muscles will probably get you much better results without any of the trauma.

Clients often think surgery is the answer to their problems, but what they don’t realise is that after the surgery there is a long rehabilitation process. If clients just did the rehabilitation before surgery, they would have superior results without the trauma.

Laying on a table receiving ONLY passive treatment will fix it.

Passive treatment such as massage, heat, manipulation or adjustments is helpful for the early stages of back pain. Often this is all you need for cases of back pain that are treated early (within 6-12 weeks).

If your back pain has been going on for more than 3 months, it is classified as chronic or persistent in nature, you will need a different approach. If you have chronic back pain and you do not have a plan to work on your muscle imbalances and weaknesses, you will not achieve permanent pain relief and you will need ongoing passive treatment. This is why some people keep on going back to a practitioner for treatments week after week, month after month, year after year.

You think your back pain is due to something being ‘out of place’.

There is no evidence that back pain is caused by a bone or joint in your back being out of place or your pelvis being out of alignment. Common suggestions that back pain is caused by spinal subluxations, pelvic asymmetries, alterations in leg length, and other simple structural issues, are incorrect. Although these may be observed in patients they are not the cause of the back pain.

Having your back manipulated is not putting anything back in place as there was never anything ‘out of place’! This also applies to the common perception that discs can move or ‘pop’ in and out.
Of course, some people may experience reduced pain after having their spine manipulated or ‘popped’. It is likely that in people who report pain relief from such manipulation, the benefit may be from reducing the sensitivity or ‘activity’ of the nervous system, restoring normal joint movement and muscle activity. If your back pain comes back again, it has not fully resolved your problem and something else needs to be treated.

You are told having a bad back is normal.

Many people simply put up with back pain, thinking that it is normal, that it’s a part of ageing (often reinforced by doctors).

But there is a solution (but it’s not drugs or surgery).

Understanding that we know more about back pain today than ever before and that there is a solution to 99.9% of cases of back pain gives you hope that you don’t have to put up with it anymore.

There is no quick fix.

But if you are prepared to find experts who can help you develop an individualised treatment plan that includes corrective exercises, you can greatly improve your back pain.

1. It does not always heal by itself ( but given the right treatment it should completely heal).

Pain that has been ongoing for 6-12 weeks or more needs more than just passive treatment and/or medication to control pain.

Sometimes we strain our back after physical activity or twist the wrong way. The pain can be intense and it can seem quite bad at the time. But often this settles down within 48-72 hours. And a full recovery in 1-2 weeks.

The problem is when pain persists beyond this. The longer the problem goes on the harder it is to treat and the more you need to do to get it right.

But the good news is that there is always an answer to improve your back. But you have to get the right solution for you.

The best way to help with persistent back pain is to have team-based care from a group of back pain experts. Often some hands-on treatment will help to reduce the pain temporarily, BUT this has to be followed up with specific exercises to help strengthen and stretch the entire body. Pilates is a great example of this.

Having an expert such as an osteopath or physiotherapist guide and support you through the recovery is important. There is a solution to back pain, but you have to be actively involved in your recovery.

2. Exercise is the best option for treating back pain.

The single most important intervention that will help you reduce back pain and get a strong healthy back that is resilient is Exercise. The problem with these people is often simply told to stay active without the right guidance. Too many people try this either unsupervised or in a gym setting and they often do the wrong exercise or do too much too soon and they aggravate their back pain. This flare-up of pain reinforces the belief that they will have a bad back forever and they stop exercising. This is where you must have an expert help you with the exercise plan to get you back to full recovery. Individually tailored exercise programs have a much better success rate than a generic gym program or group pilates class.

By looking at things like your range of motion, flexibility, walking patterns and posture, and combining this information with the interpretation of your symptoms, you will soon be able to identify whether your pain is, in fact, muscular rather than structural. If it is muscular, as a majority of cases are, targeted strength training is the only answer.

A back pain expert is able to accurately assess what each individual needs in their treatment. Every person is different and relying on the same recipe based treatment for back pain just won’t work for a majority of people. The best approach has been proven to be a team-based approach to back pain utilising the distinct advantages from a number of experts. Hands-on treatment at the start for some pain relief and to help you move more freely, backed up by carefully selected rehabilitation exercises specific to you leads to long term improvements in back pain.

Not all back pain is the same.
We have helped over 20,000 people and we know who we can help and who we can’t.
We have developed a quick questionnaire to help determine those who we can help.

To get your survey sent to you directly, type Back Pain in the comments and we will send it to you straight away.

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