Treatment Tuesday: Focus on Low Back Pain

🩺It's Treatment Tuesday here at HAE🩺

With my goal of promotion of healthy aging for the patients I treat, I also think it's important to share information on a larger scale. Each Tuesday, I will review either new literature or established best-practice standards that address the best treatment for a particular disease, disorder or dysfunction. To kick things off, I choose a problem I'd be willing to bet we've all experienced a time or two....Low Back Pain.

While Low Back Pain is common, it is often mistreated. Here is a review of the recommended, most effective treatments, treatments options that are sometimes appropriate, and lastly, the few that are least appropriate and often less helpful. Primary source of this information collected from ChoosePT.com, a patient education resource guide from the APTA. See links below for more information.

RECOMMENDED: 

🟢 Movement: While it may be tempting to stay in whatever posture doesn't bother your back, the more effective treatment  is movement. Try to move more in ways you can tolerate - walking, swimming, cycling or simply gentle stretching can help alleviate and prevent low back pain. Consult a Physical Therapist to help you establish a physical activity plan that is safe and effective at reducing low back pain.

🟢 Education: Low Back Pain can commonly be attributed to muscle imbalances within the trunk, legs and along the spine. When you combine that with prolonged sitting, standing or repetitive motions, you get pain and dysfunction. Learning about your imbalances and about proper posture can help you take control of your low back pain.

🟢 Cognitive-Behavioral Therapy: This type of therapy (using your behavior to retraining your brain to respond in an alternative way to a stimulus) has been proven effective for any type of chronic pain. Next time you have a painful experience, notice what your response is. Do you get immediately anxious? If it happens, take that opportunity to focus on your breathing, instead of your anxiety. While you take time to be aware of your symptoms, take 5-10 slow deep breaths instead of turning to panic or googling what to do. This 'changing the conversation' can help your brain begin to dampen the response to the pain stimulus instead of turning to panic.

SOMETIMES APPROPRIATE:

🟡 Yoga: With a focus on controlled breath with movement and on core activation, yoga can be a helpful adjunct to your low back pain treatment plan.

🟡 Massage: While massage may give you some short term relief, evidence has shown movement-based therapy is more beneficial in the long term.

🟡 Acupuncture: Results of acupuncture for low back pain relief is similar to those associated with massage; while it may be helpful on the short term, it should be combined with recommended treatments for long term relief.

🟡 Spinal Manipulation: As with massage and acupuncture, spinal manipulation may help initially with function, but should also be combined with exercise and movement-based treatments.

RARELY APPROPRIATE:

🟠 Opioids: The CDC recommends use of opioid medications only for chronic pain that has been resistant to other recommended treatments. They are less effective and have considerable side effects.

🟠 Heat: Everyone loves to throw on a heat pack, but there is limited evidence of any long term benefit. Ice may be a better choice, but regardless, any use of modalities should be used in combination with recommended treatments.

🟠 Imaging Scans: Evidenced has shown that imaging like x-rays and MRI's is not necessary to diagnose and treat low back pain. It can also lead to unnecessary treatment.

🟠 Spinal Injections: Evidence has not found any long term benefit from spinal injections and it does not reduce the likelihood of surgery.

🟠 Surgery: Surgical intervention is not necessary or recommended for most types of low back pain.

NOT RECOMMENDED: 

🟠 Bed Rest: Not only is bed rest ineffective, it will likely make back pain worse. Try to move, in ways that are comfortable instead. 

To learn more about the best practice guidelines for the treatment of low back pain, check out these links:

Choose PT Guide to Low Back Pain:

https://www.choosept.com/symptomsconditionsdetail/physical-therapy-guide-to-low-back-pain

Choose PT Recommended Treatments for Low Back Pain:

https://www.choosept.com/resources/detail/recommended-treatments-low-back-pain-2

Choose PT Five Common Myths About Low Back Pain:

https://www.choosept.com/resources/detail/5-common-myths-about-low-back-pain