Management of the Back Pain Epidemic:- What does the Research Show
Low back pain is an extremely common problem that is often poorly managed. Researchers claim that back pain is second only to the common cold as a cause of lost days at work. Back pain is a particular challenge because it is so common, demanding of medical resources and a major cause of physical, psychological and social disability. Low back pain has an estimated lifetime prevalence of 84% worldwide. Most back pain is simple and self-limiting but it is important to recognise that which is not.
In 1994 the Clinical Standards Advisory Group (CSAG) published a report that radically changed teaching and practice. Until then, rest – perhaps with a board under the bed – was recommended for back pain. The new guidelines recommended active rehabilitation. The new principles of management involve keeping the patient active and giving analgesia to facilitate this. Now only in exceptional cases is rest allowed and then for no longer than 48 hours.
More recent studies have not conclusively shown one particular form of activity or rehabilitation to be better than another, but they do continue to demonstrate active rehabilitation is far more successful than passive rest. One possible reason that no one particular therapy has been shown to be significantly more successful is that rehabilitation
needs to be very individualised. Although the majority of low back injuries fall under the“non-specific low back pain” diagnosis, there are no two injuries the same and they all respond differently to treatment and exercise. This is why Physiotherapists make a thorough subjective assessment and complete a number of examinations and physical tests, to enable them to best treat each individual back injury.
There are several stages for rehabilitation of back injuries:-
• In the acute stages of a low back injury the main aims are to reduce pain and restore movement. This is done through mobilisation, massage, electro therapy and spinal stretches.
• As pain reduces and movement improves, the emphasis of treatment then shifts to improving core stability and basic strength exercises.
• The final stage of rehabilitation involves progressing the patient into a work specific and/or sport specific strengthening and conditioning program, with a large emphasis on developing an independent exercise program that the patient can self manage until they reach pre-injury function.
So in summary if you have back pain, rest is not always the answer, getting active earlier can speed your recovery. If you have any questions about back pain, or wanted to get started on a structured rehabilitation program specific to your back call 66527355 (Coffs), 6658611 (Sawtell) for more information.