Lower Back Pain Treatment: Everything You Need To Know
Lower back pain is a tremendous burden on society as well as the individual. When you’re experiencing back pain, particularly when it is persistent or chronic back pain, it can also become somewhat isolating. Because low back pain is one of those conditions which often isn’t always visible to others immediately which can make things worse.
The best treatment for lower back pain
Nowadays there are many treatments that are touted as the “best treatment for back pain” from stretching to acupuncture, injections, surgeries, and many, many more. With all these treatments to pick from, it is often difficult to know which sort of treatment will best help your particular back pain.
Part of the reason for this confusion lies in the fact that there are different approaches to back pain. The first and most frustrating one that we’ve faced over the years, clinically, would be the jump to diagnose all early back pain as muscular.
Back pain is caused by muscle spasm
If your back pain was anything less than falling off a 10ft ladder, chances are, at your first appointment with your GP or physio you’d have been diagnosed with “muscular back pain”. Fundamentally, this is saying that your back pain is caused by a spastic muscle or a tight muscle. This will quickly be followed by the classic stretching exercises and perhaps, a prescription for muscle relaxants or pain killers of some description.
This is the first mistake. No back pain is muscular. Injuries that result in back pain frequently, if not always, present with a reaction from the muscles and in the muscles. In many cases this reaction from the muscles is fundamentally unhelpful, but this does not mean that your back pain is “coming from the muscles”. The muscles are reacting to an injury in the back in a “reflexive” or “subconscious” way. Think about it; if you move in a particular manner and you get a jolt of pain, you immediately tighten up in the muscles. The muscles didn’t cause the pain, they certainly didn’t make it much better with that reaction, and they definitely tightened up but to say this is just muscle spasm is simply untrue.
If this mistake in the diagnosis of your first episode of back pain is made, it will often set things up for recurrent back pain and unsuccessful treatments going forward as such diagnoses lead to treatments completely missing the mark.
Back pain symptoms can vary from case to case and episode to episode
Some of the common symptoms that you might have would be dull aching back pain, burning pain, sharp local pain, referral pain into the buttock, and even round to the groin. You might also experience sciatic pain going down the leg and into the feet.
Sometimes it’s not really pain, it’s a numbness or a tingling. It could be a burning sensation in the lower back. All of these symptoms could be present, some could be present, and they may be there at different times or with different episodes.
Fundamentally however, they all come down to the same issue, an injury to the lower back and its respective joints. Once we understand this, we can start to approach treatment in an intelligent manner. If we fail to grasp this and still work to the “it’s a muscle” hypothesis we will miss the bigger picture and never address the cause. Not only that, but in many cases the treatment approach we would take would likely lead to making the underlying problem worse!
Treatment should target the cause of back pain
A good knowledge of how the lower back works is important to understand how it is injured. The primary role of the lumbar spine is to load bear. It is under the stress of this load, that it fails. The lower back has some quirks to it as well, these can make issues like inflammation build up more troublesome. In the cause of inflammation built up in the lower back, this can create the urge to undertake certain actions that will not be helpful to the cause of back pain – in spite of the fact they provide momentary relief.
For example, the knee hug has the effect of alleviating pressure that may have built up temporarily in the spinal canal and exit foramina – these are holes in the side of the spine where the nerves come out. By hugging your knees you enlarge this hole providing a temporary enlargement of the space. The problem with this is that it also creates a stretching force on the tissues that have already been stretched and damaged. This is akin to pulling the opposing sides of a paper cut on your finger apart – reopening a wound that’s trying to heal – resulting in flaring up of the injury.
Instead of this misguided approach treatments that facilitate healing should be priority, alongside methods that do not make the underlying problem worse.
The best treatments we found for low back pain
Over the years, we had experience in running our clinic in central London with what we had perceived as being the best treatment combinations available. The result of this was winning of the Queens Award in 2020 as well as numerous items of coverage in national press, such as in the Daily Telegraph in 2018.
The first step of treatment was to unload this loaded structure, gently taking pressure off this injured region of the lower back. For this treatment we used IDD therapy. A large machine that patients would lie on with straps to gently and rhythmically stretch the lower back targeting the primary load bearing section of the lumbar spine, the intervertebral discs and bodies.
In many cases, it is only after much trouble that you may well end up being referred for an MRI scan, only to be told the disc is bulging or “slipped”. Whether minor or major, in many cases of lower back pain, there is some degree of involvement of the disc itself. Moreover, unloading these discs is tremendously helpful in all cases of lower back pain!
The converse is also true. That many, perhaps even you, reading this now, will find that when you have back pain, the more you put pressure on your back, the worse it is!
The second step of treatment was to provide a mechanism for reducing inflammation and promoting tissue healing. For this task we employed the use of class IV laser therapy. Specifically the K-Laser. This top of the range healing therapy was used on even the most acute cases of lower back pain to provide some targeted relief to the lower back.
Sometimes lower back pain can be so severe the person can barely move. By having a modality of treatment available for back pain, that is painless & requires nothing of the patient, you can kick start the healing process right away on even the most sensitive patient. This is another example of back pain treatment that is specifically aimed at the cause of the problem – the injured tissues and structures in your lower back.
Treatments for back pain that help you get better
We also included additional treatments, as stiffness in joints and tightness in muscles is still unfavourable, in spite of our previous comments. So work would also be done to these areas using joint adjustment and muscle vibration, the safest and most effective way of providing this type of treatment to the lower back.
The important thing to notice with this part of treatment to the lower back however is that the joints are going to stiffen up again, and the muscles are going to tighten up again so long as the injury is there. They are also not directly addressing the cause of the problem and we cannot isolate a living person from all the many “bad activities” they will be doing every single day. More on how to overcome this challenge later…
That being said they do provide some help to the treatment as a whole and so are worthwhile doing. We draw this distinction only because it is important that you understand what a specific treatment is doing for your back pain and how these different interventions are contributing to your overall recovery process.
WARNING! No treatment for back pain is complete without this
In spite of this great treatment technology available there is one thing that no treatment can do for you, strengthen your body, and get you moving correctly. This is why rehabilitation is possibly the most important part of the treatment for your lower back pain.
The reality is that even if you’re fortunate enough to be able to afford to have treatment like that we mention above daily, no-one can address the two aforementioned parts but you. Correct movement and strength is something that you can only build with time & effort.
Clinically rehabilitation was just as important as the treatment, if not more. With the overwhelming majority of patients simply not being proficient in either. Having the right sort of back rehabilitation program is an essential part of back pain treatment.
If we suppose you did have 1 hour of the excellent treatments we mentioned above, every day of the week you’ve still only spent 7 hours of the week on this. Leaving another 161 hours every week for you to be “doing your own thing”. Aside from the fact this would amount to a small fortune, if we do not have strategies for improving this significant amount of time every single day we are missing a huge part of the picture. This leaves you with ample time between these hypothetical daily treatments to undo all the good work. If you have the right rehabilitation however you will be able to spend additional time at home making your recovery even more robust and long lasting!
Treatment for back pain now
If there is one thing that has proven the effectiveness & importance of the right back rehab program it has been the creation of the Back In Shape Program. What we have seen over the years is the miraculous effect that a patient can have on their own back pain when they are given the right tools and education with support along the way.
We mentioned in the previous section this “extra time”, the time you spend “living life”. By providing guidance on how to make small changes, as well as having the right exercises to build your back resilience, you have a huge ability to make significant changes at home and contribute to getting out of pain every day. What’s more, the cost compared to daily treatments, weekly treatments or even monthly treatments is comparatively tiny!
Just like there are correct and incorrect treatments, exercises are no different. It is the underpinning philosophy of these exercises and the progression of a program that leads to success in treatment of back pain. Doing silly movements like knee hugs or child’s pose are examples of common exercises that completely miss the mark but are prescribed as standard. This is because they’re based on a lack of understanding.
We have seen that when patients with objectively challenging diagnoses go through the Back In Shape Program as a form of treatment for their back pain, from home, they can get remarkable results. We know how remarkable these results are, because they’re the same sorts of patient diagnoses we would have seen in clinical practice.
Examples of the conditions that members of the program have had include: disc bulges and disc herniations, spine arthritis and spondylosis. Even those with chronic back pain, post surgery and with more severe conditions such as spondylolisthesis or previous injections have had success. They find that when they fully embark upon this comprehensive way to treat back pain, with expert support, from home, they’re able to take the small daily steps towards recovery and see results that last!
The power to treat your lower back pain at home
The thing with this approach to treatment for your lower back pain is that it costs a lot less, but it’s all on you. You’re given the tools you need, the program to follow, and the support necessary, to get it done along the way, even if you run into trouble. However, when you go to a clinic and pay hundreds of pounds for treatments, or thousands of pounds for more invasive procedures, what inevitably happens is that the problem of your back pain is passed to someone else.
This is the trap.
Therefore the motivation to complete the exercises, learn to move properly again, and make simple changes to your day to day activities is significantly decreased. The time isn’t invested in the same way, even though the need to correct your movement and lack of strength is still there. It’s unavoidable and in spite of best intentions having spent many years treating patients we know it’s unfortunately frequently the case.
The result here is that you may well have a successful intervention, but the problem comes back, again and again. Maybe in a month, maybe a week, maybe a matter of hours or days. And when it comes back, the fear that you’re going back to square one comes with it.
This is why having the power to treat your own lower back and have tools that you can use every single day, if necessary, is so powerful. It truly is the best treatment for lower back pain and arguably, the only long term treatment.
If there is one thing we’ve learned being on the clinician side of this back pain equation, it’s that, you can have the best treatment technologies in the world but only the patient has the power to truly fix their back pain for good. Our role now is to help you get your; Back In Shape.
I’m starting IDD on 28th June for 2 bulging discs L5/S1 & L/4/L5 with another practice near Southampton who follow the same principles as your team. Since Xmas 21, I’ve seen 2 physios that just want to give me a load of stretching exercises that make the problem worse as you describe. Lack of knowledge in the medical community about the causes and proper treatment of lower back pain is the biggest burden on society. If they understood the fundamental principles and correct treatment like you guys, I doubt there would be so many members of society suffering for weeks, months or even years!
Hope all goes well with this Warren, the treatment will no doubt go well in conjunction with your good rehab work 🙂
Thank you so do I. If not I’m coming to visit you guys!
Thanks Richard 🙂