The Complexity of Low Back Pain
- Posted on: Apr 21 2021
Low back pain is one of the most common reasons why the general population seek physical therapy. In recent years, there has been a significant increase in the use of MRI’s, spinal injections and various medications in order to provide patients with a pathoanatomocal explanation as to why they are feeling their pain and to provide immediate pain relief as well. However, studies have shown that abnormal MRI findings are not the best predictors of low back pain. Evidence has shown that most of these abnormal MRI findings are also common in people who have no symptoms whatsoever. This is why many approaches to treating low back pain such as cortisone injections or epidurals only tend to provide patients with short term relief.
There is a growing belief amongst clinicians that low back pain is a multidimensional disorder. While tissue or joint related pathology may be a factor, this should not be attributed as the only cause of pain. Various studies have shown that low back pain can be viewed as a protective mechanism produced by the body’s systems in response to perceived levels of danger, threat, or disruption in homeostasis, which is the physiological state of balance between various elements in the body. In light of this knowledge, many clinicians believe that low back pain is influenced by a plethora of factors such as levels of physical fitness, exposure to lifting/loading, psychological states and emotions, stress levels at work and at home, sleeping habits, amount of activity in a day, and other illnesses that may also be present such as obesity. In addition, there are also those factors that cannot be modified such as genetics, age, sex, etc. This is why it is important for clinicians to ensure that the patient is evaluated and treated in a holistic manner, in such a way as to not only focus on musculoskeletal factors. It is also important to establish efficient communication in order to provide education on pain science, avoidant and protective behaviors that may be detrimental to the spine, and improved sleep and dietary routines.
Posted in: Low Back