I Stretch Daily But I Still Have Back Pain, Will I Eventually Need Surgery?

Dr. Tom Padilla -Ask e Physical erapist

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Question: I have back pain and I feel like I’ve tried everything to help it. I’ve tried massage, acupuncture, chiropractic, stretching, exercising, you name it. e problem is, everything seems to help a little bit, but only for a short while. I’d like to avoid surgery, but I’m concerned that nothing seems to be working. Can this sort of thing be helped?

Answer: Hi Shannon, thank you for your question about back pain, and whether or not there is a solution without surgery. is is a great question and back pain can be quite confusing (for healthcare professionals as well!). For anyone struggling with recurrent back pain there are a few things that are important to understand.

First of all, muscles are not smart. ey do not have minds of their own. Typically what happens in back pain is that muscles in your back have gotten progressively tighter and more sti over years and months of recurring back issues. Eventually this muscle tightness causes irritation in the joints of your back, and can even add additional pressure to the discs and nerves. Any of these areas can give you pain, for example: your pain may be caused by the tight muscles, the compressed joints, the discs, or the nerves. What’s important to know, is that none of this is the ROOT CAUSE of your pain, it’s the RESULT of a bad pattern.

Let me explain. e REASON a muscle gets tight in the rst place is to compensate for another muscle not doing it’s job, or to protect an injury. It’s the brain that tells it to do this, and at rst it’s a good thing because it allows us to heal and keep moving. e problem is that the brain is really good at learning new patterns. So this pattern of using the bigger muscles gets stuck in the brain. So the muscle now begins to be used for everything. Over time, the brain forgets to use the other muscles to support the back and these muscles atrophy (get smaller and weaker).

Second thing to understand: is is precisely why all of those treatments you’ve tried give you temporary results. ey focus on the tight muscles, sti joints, or nerves. While massaging the tight muscles, and opening the joints give temporary relief from the pain, the pattern in the brain remains unchanged, so gradually your symptoms return.

If you want to make lasting changes, what you need to do is change the pattern in the brain to get it to use the right muscles. Many people will confuse this with focusing on “core” exercises or needing to strengthen the small muscles. is leads me to the third thing. If you just jump straight into movements like squats, planks, and bird dogs, your body will continue using the wrong muscles. You have to nd someone who can help you gure out which muscles to target, as well as avoiding targeting the ones that are already compensating.

Now, I’m not saying that all back pain can be xed without surgery, there are cases in which surgery can be a great option when the damage that’s already been done is too great. It depends on what your speci c situation is with your back. If you are considering back surgery, know that “prehabilitation” is also possible. Meaning that if you work to get stronger before your surgery, your outcome will also be better.

Now that we have that covered Shannon, if you have periods of time where you are able to be active and your back does not hurt, chances are that there is still something to be done without needing to consider surgery. e fact that there’s a situation in which your back does not hurt with activity, means that with some good detective work it can be gured out how to make that situation more permanent.

Here are some tips to start making some changes in your daily pain quickly while you gure out your next steps:

1. Make sure you’re not crossing your legs, this includes while you sleep, put a pillow between or under your knees.

2. Keep MOVING: Bedrest is not good and will only worsen the muscular patterns.

3. Drink plenty of water, at least half of your body weight in ounces daily.

If you try these suggestions and are still having trouble, before you get surgery come see us at “ e Doctors of Physical erapy.” We can help you analyze your movement patterns and which muscles your brain is favoring and help you understand what’s going on with you speci cally. Even if you have had physical therapy before, our “PHIX your back” program has helped many people in Arizona continue staying active without having to go down the route of surgery.

Shannon - whatever you do, nd ways to keep moving and living your life!

Dr. Tom Padila is a Doctor of Physical erapy and owner of e Doctors of Physical erapy in Scottsdale. If you have a question you’d like him to answer, call DPT at 480-482-0651, or email him at info@thedoctorsofpt.com. For more information about Dr. Tom and his clinic, visit www. thedoctorsofpt.com