What Everyone Should Know About Lower Back Pain
Lower back pain is the most common problem I see in the clinic. While sometimes it can be caused by a serious pathology, or referred from another part of the body, the majority of lower back pain can be classified as simple mechanical low back pain. I would recommend being seen by a physician or physical therapist to determine your best course of action.
Once it is determined physical therapy is appropriate, there are many options available. Many people will come into the clinic with recent x-ray or MRI reports in hand and look terrified. They may have briefly talked to their doctor about what came back on the results. This can be anything from a negative result in which case the patient is confused about why they are having so much pain and dysfunction to something along the lines of a herniated or bulging disc, stenosis, or the dreaded arthritis. I like to stress to the patient that while these types of diagnosis can certainly cause pain, they don’t have to cause pain and dysfunction.
There is a growing amount of research demonstrating that findings on imaging (an MRI or x-ray for instance) do not necessarily coincide with symptoms. So in one of my favorite studies a random sample of people were pulled off the street, people who had never had a problem with their back. The researchers took an MRI of the pain free subject’s back, and were expecting to find “normal” MRI results. But that’s not what the researchers found. They discovered that the asymptomatic people in the study had MRIs that showed herniated and bulging discs (but never had any pain!). So this is just one example of an MRI result not coinciding with symptoms. So I tell people, just because you have a bulging disc (herniated disc, spondylosis, spondylolisthesis, degenerative disc disease, stenosis, and/or arthritis) on your MRI it doesn’t mean you have to hurt. In many cases the problem seen on your MRI or x-ray isn’t even the reason you’re hurting. Sometimes that problem has been there for a while and has not caused a problem.
So I want to tell you that there is hope. This leads us to the next question, and it’s a good one, “What can physical therapy do for me (especially if I have X, Y and Z on an MRI)?” Physical therapy can eliminate your pain and get you functional again. Physical therapy doesn’t take away your stenosis, arthritis, or issue that is showing up on an MRI or x-ray. It can however address your underlying dysfunction which is causing the problem. Physical therapy can help to get you in a better position, move better, improve the way your nerves are moving, and get your muscles to turn on and off at the right time. Physical therapy can sound very simplistic – I like to think of it as giving your body a subtle but powerful nudge in the right direction.
If you’re having low back pain and have some unanswered questions, please feel free to contact me.