This is something that annoys many in the allied health field – why do we treat a back so differently to many other joints? You might be wondering what I mean by this…I mean that when people come in with say, knee pain, we aim to reduce the pain, increase the movement and then gradually load the joint back up to better than pre-injury levels, or as I like to tell my patients – we calm stuff down and then build it back up.
So why don’t we do this with your back?
The back seems to be a problem area for many therapists across all disciplines. I’ll admit that it can seem to be a complicated joint when you look at every single little thing that could go wrong. It can be overwhelming! Your back moves in many different planes and is incredibly strong, whilst incredibly mobile! Just think of the incredible feats of strength you see people doing WITHOUT injuring their backs!
I think that this may be the reason that it typically isn’t treated effectively and if you’re reading this then I can almost guarantee that you have, or have had, frustrating back pain. So if you’d humour me for a few minutes, let me offer a solution to your pain… there is HOPE for you yet!
Pain is pain
Forget muscle pain or nerve pain or joint pain, it’s all pain and it all needs to be dealt with accordingly. We have so much amazing research now, which I won’t bore you with, that gives us the tools to help you decrease and be in control of your pain. Your perceptions about your pain will be far more important than ANY structural damage!
Don’t believe me? I wouldn’t either, WHO EVEN IS THIS GUY!?
A study in 2013 found NO DIFFERENCE in outcomes between patients given a sham clean out surgery of their knee compared to the real surgery. So what does this mean for you and YOUR BACK? It means that if you believe in the treatment you are receiving then your pain will decrease! That’s huge!
So what is the next step?
Combining the research of WHAT ACTUALLY WORKS with a therapist who understands how to implement it and guide you through the program!
What about my scans?
Throw them in the bin….Seriously! Have a look at this fascinating graph below from Adam Meakins (The Sports Physio)
What this shows is that degeneration and pain are not interrelated! In fact, think of degeneration as you think of wrinkles and grey hairs – annoying, maybe; but painful? No!
So let’s put the scan away and focus on what really works to FIX YOUR BACK…Manual therapy, movement and strengthening!
Your back is built to move
It kills me when I hear people say, “Ohh I just can’t do that anymore, my back can never get better – my back pain physio told me to change my lifestyle to avoid certain activities.” This is a nonsense and lazy approach to treating backs!
The truth is your back CAN and SHOULD be able to go through the full range of movement and, by avoiding movements, you will develop more stiffness, pain and decrease movement further. Avoid all movements that hurt suddenly doesn’t seem like such great advice anymore does it?
So what does help my back?
Manual Therapy – This is such an effective tool to reduce pain initially and to get you feeling like you can move again, BUT…it shouldn’t last forever and if it does, I hate to say it but that therapist is taking you for a ride!
Mobility – It’s so ESSENTIAL that we get your back moving, and moving well, through all planes of movement as soon as possible so prevent further issues that you may face in the future from not using it! Have you ever had your arm or leg in a cast? How incredibly hard was it to bend your elbow/knee when you got it off? It was so STIFF and PAINFUL right? It’s the same with your back, if you guard the movements, everything else around it will tighten up and then normal back movements will BECOME PAINFUL!
Strength – I say it over and over, but that’s because no proper back treatment can be complete without a strengthening program. In order to FIX YOUR BACK PAIN and prevent future issue, we need to work together to strengthen the muscles that support your back. When your back muscles are weak, they get tired easily and that makes them spasm and, what happens when muscles are overworked and spasm? You got it! They become painful! And contribute to YOUR BACK PAIN!
But there is hope…
We’ve helped many other people in back pain, just like you, to become pain-free and enjoying their life again!