Are we getting better at managing low back pain?
There is a worrying trend in low back pain management. This has been highlighted by a recent series of articles in the Lancet Journal. These articles are asking the medical profession to stop offering ineffective and harmful treatments for back pain. There is an escalating overuse of strong painkillers, injections and surgeries. The concern is that the current health-care approaches are actually contributing to the overall burden rather than reducing it.
Globally, years lived with disability caused by low back pain has increased by 54% between 1990 and 2015. Therefore making it the leading cause of disability worldwide. Highlighting this very point.
What is back pain?
Low back pain is a symptom not a disease! For nearly all people presenting with low back pain, there is no specific definable structural source. They are therefore classified as having so-called non-specific low back pain. It is other elements such as psychological, social, and biophysical factors which contribute to the pain. It is why treatments targeted at the structure have been ineffective. Hence the call to action.
Only a very small proportion have a pathological cause where further investigation is required. Importantly for most back pain, no evidence exists that imaging improves patient outcomes. Guidelines consistently recommend against the routine use of imaging for people with low back pain
The good news?
Most people with a new episode of acute low back pain recover quickly. It is not uncommon for it recur in the same year, but again, this will usually resolve in a short space of time. The aim is try and get back to valued activities as quickly as possible. Returning to normal life is essential for both our physical and mental well being.
For a minute percentage symptoms can become persistent. Psychological, social, and biophysical factors are generally more prevalent with persistent pain. Learning how these elements can influence back pain is key to getting it better. Understanding strategies to improve and control the pain is the beginning of the journey to getting it better.
Physiotherapy can play an important role in helping a persistent sufferer on the road to recovery. Guiding that individual on the way back to a life that they value and find fulfilling.