Sunday, March 5, 2017

New Treatment Guidelines for Low Back Pain

Back pain is one of the most common health complaints, and it is also the most common source of physical disability.    Sadly many people find themselves on opioid pain-killers for low back pain which are highly addictive and kill over 16,000 Americans each year from over-doses.
The great news is in the majority of cases there are better ways to manage and prevent low back pain.     One of the most important facts to understand about low back pain is that 75 – 80% of low-back pain will resolve themselves within 2 – 4 weeks without any treatment – particularly if the low back pain was caused by strain, overlifting, twisting, car collision, etc!
Another common cause is too much sitting which is why standing more is part of the solution to many people’s low back pain.    While seated, we tend to allow the low back to go into flexion (round) which places stress on the discs between the vertebra for prolonged periods of time.    In addition, the hip flexor muscles which extend from the low back to the femur (upper leg bone) get chronically shortened and pull on the low back!
Moving is a key part of the solution
The new guidelines stress that movement is very important for almost all forms of low pain along with controlling inflammation, and improving muscle strength, endurance, and mobility.
It is very important to move when you are experiencing low back pain as well – this is not intuitive because initially movement may increase pain.   However using gentle, controlled movements like yoga are very important to resolving low back pain.  
Exercise is also very important for the prevention of low back pain.    For people who have a history of low back pain, exercise is the most effective way to prevent a recurrence according to a recent research review of 21 studies.
Strength training, cardiovascular exercise along with stability and mobility training are all effective in lowing the risk of low back pain.
New Treatment Guidelines Stress Non-Drug Interventions for Back Pain
Early this year, the American College of Physicians issued updated treatment guidelines for low back pain eliminating medication as the first-line treatment and recommending non-drug therapies first.

The new guidelines include three primary recommendations all of which focus on alternative treatments and physical activity.  This includes discouraging the use of Steroid injections and acetaminophen (Tylenol) because research shows that neither is beneficial.
Treatments such as massage, acupuncture, heat, spinal manipulation, tai chi, lower level laser treatments are all first line recommended options.   Non-steroidal anti-inflammatory drugs are also recommended such as Ibuprofen.
Scans and Surgery Are Useless for Most Cases of Back Pain
According to the American College of Physicians, scans like MRIs are also to be avoided, as they're "worse than useless" for diagnosing back pain. Exceptions include cases where pain is from trauma or there are warning signs of another condition.
In the vast majority, disc degeneration does not cause back pain. In many cases, this can lead to a diagnosis of disc degeneration and result in an unnecessary surgery, which fails to resolve pain in many cases and creates its own set of issues.
Spinal fusions for back pain have a success rate of about 20 to 25 percent. For 75 to 80 percent of these patients, the surgery simply results in lifelong pain and suffering.
Exercise and Non-Exercise Activity is Key in Treating and Preventing Low Back Pain
This includes avoiding sitting and being aware of posture when you are seated.   Take frequent standing breaks from sitting.     Stretches for the hip flexors and hamstrings along with core strengthening exercise like Pilates and Yoga can work wonders in preventing and treating low back pain.

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