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Causes of Low Back Pain
Tags: back pain, back pain management, back pain relief, low back pain, Low back pain relief, low back pain treatment, natural pain relief, physical therapist Prescott, physical therapists Prescott, Prescott physical therapy
When someone has low back pain the first question they usually ask is, “Why does my back hurt?” They want a diagnosis, an explanation of why they are in pain. For many, knowing why something hurts is comforting in and of itself as it gives understanding to the problem.
When it comes to low back pain, an exact diagnosis is unlikely. Over 85% of low back pain is classified or diagnosed as non-specific which means that an exact tissue or cause is not identified. Your diagnosis depends on what type of healthcare practitioner you see. If you see a medical doctor you’ll likely be told you have a strain and they will prescribe pain medication or anti-inflammatories. If you see a chiropractor you may be told your spine is out of alignment and needs to be adjusted. If you see a physical therapist you may be told you have a muscle imbalance. There is nothing wrong with any of these explanations or diagnoses. They are all attempting to explain to the patient why they are in pain.
While this is acceptable it’s important for the patient to understand several facts. First, non-specific low back pain can and often is the result of several tissues being injured. This can include muscles, joint, discs, and nerves. It can include more than one of these tissues or all of them at the same time. Second, most low back pain heals on its own within six weeks regardless of the diagnosis or what tissue(s) are injured. Third, and the most important piece of the non-specific low back pain puzzle, is not what tissue is injured but WHY that tissue is injured and what you do while you’re injured.
The question “Why does my back hurt?” is asked and answered wrong. It is both asked and answered with the focus on WHAT is hurting, i.e. which specific tissue sustained the injury. Specifying the tissue that is injured does not promote healing. Healing is determined by focusing on WHY you are in pain and how you solve that problem. In focusing on this, you obtain a positive outcome which is being pain-free and capable of doing whatever you feel like when you feel like it. If your back pain is something that has had a slow onset and has progressively become more severe and/or more frequent over time, the “Why does my back hurt?” question is important to ask. If this is not answered you may never actually shake the pain altogether. The key is to ask KNOWING what information you need. If a healthcare practitioner tells you that you have a disc problem, a muscle problem and/or a joint problem, what does this really mean? Does it give you any information that informs you about how you should move or treat the problem? Not really. So it’s essentially worthless. You need a functional diagnosis not an orthopedic diagnosis.
If you injured your back during a fall, moving furniture or playing with the grandkids, it should heal over time. If the pain has come on over time and now you are unable to get rid of it, you have to figure out what sustained positions, postures, and frequent movement patterns are contributing to your back pain. If you do not determine what is the root cause of the pain it does not matter what treatment routine or regimen you find, you will not gain complete pain relief as you are not treating the problem. Figure out what is causing and contributing to the pain, change it, and you will find relief.
Another common question is, “What DO I do if my back hurts?” The answer to this can be very simple but is also the most important thing you can do for yourself. Modify your body positioning, movement patterns and keep moving in ways that do NOT make pain worse. Simple things such as sitting for too long without moving, sitting with your back in a rounded position, or a repetitive movement pattern could be contributing to your pain. Standing up every twenty minutes, sitting with the correct curve in your low back, or changing a repetitive movement pattern will make a noticeable difference in a short amount of time. Take note of the movements that increase your pain and repeat those movements as little as possible, if at all. If you must repeat these movement patterns, modify the movement so it’s pain-free.
Now let me debunk a common myth regarding back pain: If my back hurts, I need to move as little as possible so that it will heal. This myth is completely FALSE! The more you move and stay active, the faster you will heal. This is not an opinion but a FACT! Staying active and moving often requires that you modify your daily activities, positions, and movement patterns in a way that you’re able to move without making your pain worse. This is not to say that staying active means ‘no pain, no gain’ or that you should push through severe pain. It means to find ways that you’re able to move and continue your regular activities without severe pain. Many people prop up in bed or on the couch thinking this will help the pain go away which is the exact opposite of what you should do. Bed rest or essentially immobilizing yourself will increase the time it takes your back to heal and has the potential to make matters worse.
So remember, it’s understandable to want to know why your low back hurts and to want a diagnosis or explanation but more important than this is determining what makes your pain worse, modifying painful positions or movement patterns and then staying active. This determines the outcome, not knowing which tissue is injured. So ask “What makes my pain worse?” Not “What tissue is at fault?” A tissue specific diagnosis does next to nothing other than make you feel better because you “know” what’s wrong. You want a functional diagnosis. A decent healthcare provider can help you with this or just pay attention, use common sense and modify your positioning and movement patterns in a way that you’re able to move without making your pain increase. As pain decreases, movement will improve and you can slowly resume activities that were once painful. You will eventually reach a point where you can begin to train your trunk and low back so it’s more resilient and injury proof. I’ll write more on how to do this in a future post so be sure to check back in with us!