"My favorite childhood memory is my back not hurting!"
- Random bumper sticker
Low Back pain is something that over 80% of us will experience at some point in our lives...and it sucks! The pain is so intense, it's hard to know what to do. One in three adults say back pain impacts their everyday activities, and we spend $50 billion annually in the United States on treating this condition. Yes, that’s Billion...with a ‘B’! Unfortunately, much of these costs are for unnecessary and ineffective things. Ever wonder why your deductible or co-pay is so high??
Some of this can be prevented by getting the right information out there to the people who need it. If you have back pain, keep reading. If you don't, keep reading...because most likely you will at some point! Here, I'll share with you the 3 most common questions I get in the clinic. And honestly, they're the ones whose answers seem the most surprising to people. So let's clear up a few rumors.
Do I need an MRI or X-ray for severe low back pain?
No! Pretty simple. And here's why. When you throw your back out, the pain is intense...like 11/10 on the pain scale! I know because I've done it too. It's only natural to assume that something is broken and you need to get some imaging done to find out. But...we know from several research studies now that the intensity of pain in your back is not correlated to actual tissue damage most of the time. Surprising, right?!
Now don't get me wrong, an MRI would surely find some things...like bulging discs, degenerative changes etc etc. Did you know 1 in 3 people in the 20's have these findings, but actually have no pain?? That's right...20s! That number increases every decade up to 96% by the age of 80...all in people without pain. So we can see why getting an MRI wouldn't really help us sort out what's going on.
Even crazier, is that other studies have shown that people who get an early MRI for low back pain actually have WORSE outcomes! Higher ratings of pain and disability...and are 3x more likely to end up having surgery! This is because of what we just talked about. You get an MRI, it shows a bunch of scary stuff, and you (and unfortunately many doctors) assume this is what is causing the pain. When in reality, it's not!
The initial course of care recommended is always the conservative route, like Physical Therapy. Treatments like this are based on how your pain is presenting...not on the imaging findings. So an MRI also won't help your Therapist decide what to do! Although there are a few exceptions, you can see the reasons stacking up to stay away from early imaging...just don't do it.
Is bed rest good when I throw my back out?
I know the pain can be excruciating when you get an episode of low back pain. The natural instinct is to lie down, be still, and not move. But this is actually the worst thing to do! Studies have shown that an earlier return to activity leads to faster pain relief. Motion is lotion!
Now I'm not saying that lying down and resting is totally bad. It's necessary to do when the pain is very severe. Just don't stay there for too long. Have somebody help you if needed, but try to get up at least every hour and move around to the best of your ability! When we move, inflammation gets pushed around and new cells get brought in that help the healing process. When we don't move, swelling and fluid just accumulates and makes it even harder when you do go to get up. This is the same reason we can feel stiff in the mornings!
When the pain is intense, I know it feels like something is damaged. But we already talked about how this isn't true! That's one reason some people avoid moving around...because it hurts. Please understand that changing positions and moving, while painful, will not damage anything further. So if you want to get better faster, go against your natural instinct and avoid bed rest like the plague!
For a full review of what to do when you throw your back out, watch here!
Is it bad to bend my back and lift?
This one will surprise you, because it's different than what you've been told your whole life! Bending your back is a movement that we do many times through the day. Picking things up, putting on socks, getting things out of the trunk, etc. We can't avoid it! Studies show that even when trained weight lifters squat and try to keep the back straight, the spine still flexes through 75% of the maximum range! So we likely can't control it even if we wanted to!
Other studies have shown us that squatting vs bending to lift has no impact on our likelihood of hurting our back. Kind of surprising! I know some studies show that repeated flexing will eventually damage a disc. That's the reason this rumor got started in the first place!! But our living discs are adaptable. Research shows that when we bend and then allow rest...the discs actually get stronger! We need to allow our back to do what it's made to do...BEND!
Now if you're currently dealing with back pain and bending hurts, then by all means...avoid it! But just do it temporarily. When your back is better, slowly re-introduce bending again and don't be afraid to load it a bit!
I am aware that this is a VERY brief overview of this topic...not super compelling to just take my word for it. If you want a very thorough, in-depth look into the details behind what I'm saying, then you should watch here!
I hope this helps clear a few things up regarding low back pain. If you have any questions, ideas, things you'd like to learn more about...then click below
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