5 Of The Best…....Tips to manage Low Back Pain
Low back pain is an extremely common disorder and is the leading cause of sick days, reduced productivity in the workplace and disability in the western civilisation accounting for 11% of the total disability of the UK population!
Approximately 84% of people will suffer with back pain lasting up to 6 weeks in their life time and many of these people may go on to develop chronic low back pain (pain lasting more than 3 months).
85% of low back pain is defined as ‘non-specific’; this means that there is no accurate way of determining the cause of back pain but it is likely a mixture of joint, muscle and nerve pain.
Here are 5 of the best tips to manage low back pain:
1: Don’t rest too much!
Current research shows that those who manage their back pain with prolonged bed rest (more than one day) are more likely to go on to develop longer lasting back pain. It is recommended that you take an ‘active rest’ approach. Try your best to do all of the things you would normally do and modify your activities as necessary. For example, if you normally walk 20 minutes to work, take a short rest half way. In most cases you will find that your back pain is better after a day of gentle activity.
2: Use pain medication (appropriately)
‘Appropriately’ is the key word here! Often people may have a negative attitude towards the use of pain medication, however if utilised well, pain medication can help you return to your normal activities and thus avoid over-resting and enable a speedier recovery. Try using the medication as and when you need in order to facilitate normal activity. It is recommended that you always follow the instructions on the medication regarding dosage. If you are unsure of the appropriate medications to use then book an appointment with your GP who will be happy to give some advice.
3: Don’t request imaging such as X-Rays, CT scans or MRIs (unless you have red flag symptoms)
You may often hear the term ‘slipped disk’ which is a very poor description of a common MRI finding such as a disk bulge, herniation or prolapse. However people who have no history of back pain are also just as likely to have these findings on MRI scans and therefore this does not help us establish the cause of pain and does not help us treat it! This is just considered general ‘wear’ of our bodies and does not restrict our function. However if you experience any ‘red flag’ symptoms such as loss of strength or sensation in one or both of your lower limbs, losing control of your bowels, difficulty initiating urination or ‘overspill’, numbness around the genital region or new sexual dysfunction then it is important to discuss this with your doctor who may consider sending you for a scan to rule out ‘Cauda Equina Syndrome’ (hyperlink to NHS choices website). It is important to note this is only present in approximately 0.01% of the low back pain population.
Exercise has been demonstrated as the single best approach to managing and recovering from low back pain. Previously, treatment was often orientated around strengthening your ‘core stability’ muscles, however more recent evidence has shown there is no single best form of exercise and that just a gentle re-introduction to any regular exercise routine is equally beneficial. Hydrotherapy has lots of evidence to support rehabilitation of low back pain and is particularly useful in those people who have highly irritable back pain as being in water offloads a lot of your weight from your lower back. It can also be a fantastic way to manage long term low back pain for the same reason!
5: Learn about your back pain
Evidence shows that back pain is much more likely to last longer in those individuals who have a poorer understanding of their symptoms e.g. the belief that something is damaged. 90% of people will have a complete reduction in their symptoms within 6 weeks with simple strategies such as managing the pain with movement, pain killers, and exercise! Only 0.01% of back pain is due to serious pathology and most of the time there is no injury at all! Back pain can often be an ‘overreaction’ of the nervous system. This is a subconscious process whereby the brain mis-interprets the information it receives from the low back. The brain analyses all information from the low back (temperature, pressure, etc.) and can incorrectly perceive this information as potentially damaging to the body, and therefore gives you pain as a response. This is known as ‘central sensitisation’. This process is reversed by a gentle return to normal activity utilising the strategies outlined above to enable the brain to analyse information correctly again and reduce your pain.