Decoding Back Pain

Contributed by Matthew Riordan, Professional Physical Therapy & Training

An alarming 80% of adults suffer from some sort of back pain. If the source of your low back pain is a mystery, you’re not alone: 9 out of 10 people with back pain don’t know the primary cause of it. Hearing or reading the diagnoses like “Herniated Disc”, “Spinal Stenosis”, “Degenerative Disc Disease (DDD)” and to top it off, “Spondylolisthesis” (spon-di-lo-lis-thesis) can almost make your back hurt even worse!! The fear or misunderstanding of these terms can lead you down some dangerous paths, including uses of opioid medications, losing your mobility, loss of fitness and sport participation, missing time with family and friends, sleep loss and can often lead to depression.

1. “I blew my back out” or “I slipped a disc” – People sometimes exclaim. They view this as an isolated event. Often there are many factors that have created this condition over time even though the symptoms have come on suddenly. These factors may include sitting too long at work or while commuting, repetitively straining activities or even improper form with exercises. Regular changes of position or strategic stretches throughout the day and making form your first priority with exercise can both significantly reduce the potential for back pain.

2. “I should probably rest in bed until it gets better” - FALSE. Although strategic and relative rest from some activities are important, in many cases the cause for your back pain could be muscle imbalances creating uneven pull on the spinal segments. Rest may temporarily ease the symptoms, but the imbalances will become worse and having an even more painful and longer episode in the near future is likely.

3. Back Pain always radiates pain into the legs - FALSE. Since the source of pain in the back can vary, the direction or location of pain symptoms can vary. In some cases, problems in the hips could actually be causing back pain.

4. Which is better, ice or heat? – I am personally a big fan of using ice. Ice actually slows down the conduction of pain signals to the brain as well as limits any localized inflammation. I tend to reserve heat for when there is just general joint or muscular stiffness and not pain.

5. Doing exercises for back pain you found on Youtube and Google are good methods for treating back pain - FALSE. I personally have benefitted from many websites and videos for home DIY projects like building a deck, but I would not recommend trying to self diagnose and treat your own specific back pain condition. Doing the wrong thing may make your condition significantly worse.

6. Physical Therapists (PTs) are front line providers who can diagnose and treat musculoskeletal pain and injuries - TRUE. Physical therapists are functionally based and can help you get back to doing the things you love. According to a study in Health Services Research December 2018, patients with low back pain who received care from a PT first, as compared to not going to PT, saved more out-of-pocket expenses, were 87% less likely to be prescribed opioid medications, had a 28% lower probability of requiring imaging services and were 15% less likely to require an emergency room visit for acute back pain than those people who did not have physical therapy.

If you’re frustrated with your back pain and don’t want to miss out on doing things that you love, seeing the right Physical Therapist (PT) might be the best thing for you.

Our physical therapists are like great detectives. While performing a comprehensive musculoskeletal examination, we will leave no clue unturned and identify the sources of your pain. Our PTs are also trained to screen and refer to other appropriate providers if needed. Together we will develop a very specific plan to address your individual issues and begin treatment right away to put you on the path to recovery. Mystery solved.

Feel free to contact Professional Physical Therapy & Training conveniently located within the Madison and Summit Area YMCAs to help solve your back pain mystery and get back to doing the things you love.

References: Frogner BK, Harwood K, Andrilla CHA, Schwartz M, Pines JM. Physical Therapy as the First Point of Care to Treat Low Back Pain: An Instrumental Variables Approach to Estimate Impact on Opioid Prescription, Health Care Utilization, and Costs. Health Serv Res.2018 Dec;53(6):4629-4646.