I've Got Back Pain... Now What? The 5 Most Important Rules For Back Pain Management

During our initial consultations, one of the first things we do is ask our clients to tell a story about how their pain developed.  We listen to find out how long it’s been around, if any specific activities make it worse, and what doctors, chiropractors, and physical therapists have told them about their condition in the past.  Without fail, I’ll have several clients a month wince as they explain they were diagnosed with a ‘degenerative disc,’ a ‘bulging disc,’ or ‘herniated disc.’ It’s been explained to them (incorrectly) that it’s a condition they’ll have to live with for the rest of the life, and it will probably get worse as time goes on.

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A definite life sentence of back pain couldn’t be further from the truth.  While the pain that you are feeling is most definitely real, it does not have to last forever. There is still plenty of hope that you will have a pain free future that allows you to sleep through the night, lift up your kids (or grandkids), and do all the activities you love doing without frustration, fear or worry.
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So what can you do to manage and eventually eliminate your back pain?  Follow these 5 rules and you’ll be back on track.

Rule #1:  Rule out any major cause of back pain

Ask your doctor to confirm that the back pain is not related to any of the following:  cancer, infection, trauma, inflammatory disease, or cauda equina (doc will know what this means).
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Rule #2:  Question the need for imaging (MRIs)

If the doctor orders an MRI, make sure to ask why it is necessary.  The only use for an MRI is in preparation for surgery or for an epidural injection.  Getting an MRI just to confirm that there is normal wear and tear of the spine is not an efficient use of your time or money, and can actually do more harm than good to your recovery process.

Rule #3:  Think twice before injections or surgery

The research indicates that epidural injections are not effective in most cases.  They may provide some short term relief, but do very little to address your problem long term.  If the doctor recommends injections, ask him how often you’ll need injections and for how long.  The cost (in time and money) will start to add up quickly.
Regarding surgery, one poll asked 100 doctors if they would have lumbar fusion or disc replacement surgery.  Surprisingly, 99 doctors said “no.”  If surgery is recommended, ask to see the evidence that it is more effective than any form of movement based therapy.

Rule #4:  Don’t stop moving

One of the biggest keys to overcoming back pain is to get moving (or stay moving if you’re already an active person).  The more that you tell yourself “you can’t” do things because of your back pain, the more your brain will amplify the pain signals.  Whether it’s through group exercise, a personal trainer, or Neuro Therapy, pick something you can consistently perform and stick with.  Remember, pain isn’t always a bad thing – you may find that pushing through the pain a few times was exactly what you needed to get back on track towards a pain free life.

Rule #5:  Keep believing in yourself

Whatever you do, never give up on yourself.  Don’t ever tell yourself that it’s something you’ll have to live with for the rest of your life.  Don’t ever give up the things you enjoy most in life because of back pain.  Whether you’re 40, 60, or 80, you can overcome back pain – there is plenty of hope for your future!

Until next time,
Evan

Statistics and suggestions from this post are from:
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O’Sullivan K, O’Keeffe M, O’Sullivan P
NICE low back pain guidelines: opportunities and obstacles to change practice
Br J Sports Med Published Online First: 29 June 2017. doi: 10.1136/bjsports-2017-097810
 
And
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Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery by Catherine Jakobson Ramin
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