Back Pain: A Public Heath Dilemma
Back pain continues to be a major health problem around the world -- one that costs the health care system a great deal of money. Studies show that there can be minimal pain but huge disability and vice versa: significant pain but low disability. Finding a uniform way to approach the problem of back pain is difficult with such a wide range of experiences. Some patients need help with pain control while others need to improve their functional level.
Numerous studies dealing with back pain have been conducted. In one study, questions were asked about the presence and severity of back pain and loss of function (disability). The first question asked was, Do you have back pain today? From there everyone answered a wide range of questions about pain in the last three months -- worst pain, number of disability days, and the number of days pain interfered with daily tasks, social events, or work.
Other studies have shown that 80% of the adult population in developed countries will experience back pain at some time in their lives. At any one given time (during the time one survey was conducted), two-thirds (63.7 per cent) had back pain.
The take home message from this research is two-fold:
- back pain is far more common each day than was known previously and
- treatment should address both pain intensity and disability.
Physical Therapy Is Effective For Management Of Low-Back Pain--A “Cornerstone” of Non-Surgical Treatment
A new review article published in the Journal of the American Academy of Orthopaedic Surgeons promotes physical therapy as a first line of treatment for patients experiencing low-back pain. Published in February 2009, the review recommends that, in most cases of symptomatic lumbar degenerative disc disease, a common cause of low back pain (LBP), the most effective treatment is physical therapy combined with anti-inflammatory medications.
Symptomatic lumbar degenerative disc disease develops when a disc weakens (often due to repetitive strain), is injured, or deteriorates from aging. As a result, the disc is unable to hold the vertebrae as it should and the lack of stability causes back pain.
The review details the different treatment methods for symptomatic lumbar degenerative disc disease, including physical therapy with the use of nonsteroidal anti-inflammatory drugs (NSAIDs), and concludes that, in most patients with low back pain, symptoms resolve without surgical intervention. The review also concludes that physical therapy and nonsteroidal anti-inflammatory drugs are the “cornerstones” of non-surgical treatment.
Exercise and manual therapy including spinal manipulation, have been shown to benefit many patients. Patient education to remain active and use appropriate body mechanics is beneficial. Physical therapists (PT’s) are trained to identify which of these treatment strategies will be most effective for an individual patient, which further improves the effectiveness of care.
Receiving care from a licensed PT can further improve the odds that a patient can maintain their quality of life and avoid surgery, In addition to building the core muscle groups, hands-on therapy to mobilize the spine has been shown to be particularly effective.
PT’s can help patients develop a safe and effective exercise program that is tailored to an individual’s specific needs and goals. Surgery should be the last option, but too often patients think of surgery as a cure all and are eager to embark on it,” said Luke Madigan, MD, an attending physician at Knoxville Orthopaedic Clinic, Knoxville, TN, and the lead author of the literature review.