It would be surprising if you did not know someone with back pain, for it is the leading complaint seen by health professionals worldwide.
In 2018 The Lancet medical journal published a series on Back Pain. It emphasised the need for medical practitioners to recognise that drugs, injections, surgery and rest are not as effective as appropriate graded exercise, manual therapy, and an assisted mental approach to the pain due to how the brain alters pain.
The GPs who are aware of this evidence often refer their patients to osteopaths, as they understand that osteopaths are highly-trained in proven approaches to treat back pain. They only recommend the use of analgesics and anti-inflammatories as a last resort. Anyone can consult an osteopath without a referral.
Evidence-Based Management of Lower Back Pain
- i. Acute pain (under 6 weeks of pain) – see a practitioner to help you stay active and mobile and to get a professional understanding of your condition.
ii. Chronic pain (more than 12 weeks of pain) – stay active, use professionally prescribed appropriate exercises therapy, use cognitive behavioural strategies to control your brain’s regulation of the pain
- i. Acute pain – spinal manipulation (by a qualified practitioner), skilled soft-tissue therapy, and acupuncture
ii. Chronic pain – stress-reducing practices such as mindfulness/meditation (which can be done in active and non-active ways) slow and controlled exercise (such as supervised yoga and pilates) and other rehabilitation management between your health professionals
- i. Acute – non-steroidal anti-inflammatory drugs
ii. Chronic – non-steroidal anti-inflammatory drugs, certain types of drugs usually thought of as antidepressants that work on pain by changing brain chemistry and communication pathways in the brain, and invasive medical procedures such as surgery and injections.
In early 2018 article, an American medical journal reported on a study that found that back pain affected nearly half of well-functioning highly active older adults. The study found that back pain was linked to less efficient walking and poorer endurance, which can lead to walking difficulties. The lead author stated that “Older adults are living longer and healthier lives, so paying attention to conditions that may threaten independent function is increasingly important”, suggesting that better back pain management may be a factor in keeping older adults active, with less limitation of mobility.
A 2013 study published in Spine medical journal compared the effects on alleviating pain between diclofenac (Voltaren), placebo, and professional spinal manipulation. Spinal manipulation proved to be significantly superior to both other variables and was also shown to improve quality of life.
- Back pain is the leading cause of disability, particularly as our population ages.
- An estimated eighty percent or more of us will suffer from back pain at some point during our lives. It can happen to anyone.
- Upper, mid and lower back pain may be acute (new pain, or very sharp feeling) or chronic (long-standing pain).
- Back pain can range from mild, irritating and inconvenient, to depressing, severe and debilitating.
- A reported 3 million people in Australia in 2011-2012 (1 in 7 Australians) reported back pain.
- In 2008-2009 there was an impact of about $1.2 billion on the economy attributed to back problems.
- People aged eighteen or above who have lower back pain are more than two and a half times more likely to report psychological distress than people who don’t have lower back pain. This distress can be exacerbated when a patient and health-provider don’t understand each other’s issues in dealing with the patient’s pain.
- Most back pain episodes usually settle within six weeks, but, when untreated, the recurrence of episodes is common, and can become constant and debilitating, affecting everyday activities, and quality of life.
- Two-thirds of back pain persists after three months.
- Some people experience ongoing back pain for more than twelve months, though usually the pain reduces.
- Some comfort from back pain can be achieved, for most people, even if not alleviated completely.
Risk Factors for Having Back Pain
Often the cause of back pain is unknown, but we do know some risk factors for developing and sustaining back pain. They are:
- low levels of physical activity
- other lifestyle habits – such as smoking
- extra (unnecessary) body mass
- repeated and sustained postures at work such as lifting, bending, crouching, awkward postures and twisting
- bending and twisting in the same motion – even without lifting
Your osteopath will take a history to identify the risk of serious causes/contributors to your back pain, before choosing the appropriate style of treatment for you, and in order to choose the right self-management, or co-management with other health providers.