Back pain is one of the leading causes of disability in Canada and the United States, and the number of people dealing with it is only growing. Back pain is also one of the most lucrative fields of healthcare costing Americans over 86 billion per year. While the cases of low back pain increase so do the number of pain killers, muscle relaxants and invasive surgeries. The results so far have not been good.
Pain killers are in no way designed to fix the problem and are at best pain suppressors. Basically, taking pain killers are like taking the batteries out of the smoke alarm while the kitchen is burning down. You may forget it for a while, but the house (your back) is still burning down. Eventually the damage and nervous system dysfunction will overwhelm the pills and your doctor will max out how many painkillers you can take. The damage will however, still continue and unfortunately the next step is often going under the knife where a surgeon will try and cut out the problem. Sometimes it works, and sometimes it doesn’t, but regardless your looking at risky surgery a lengthy rehab program and permanent loss of motion and/or function in the spine. I have to return to the smoke alarm analogy at this point. Does it not seem like the better idea would have been to simply put the fire out when it had just started? This seems like a simple concept, but one that is often ignored. I think a large part of the problem is that most don’t realize the damage a little back pain can cause if left for years. The damage grows and becomes harder to correct as time goes on. Over time discs degenerate, muscles become fibrous, and vertebrate loose their structural integrity. Much of this damage is irreversible and why the end result is often surgery to either remove some completely degenerated bone or disc, or just screw a couple vertebrate together to correct for severe instability. This all seems to me to be a rather poor outcome.
I want you to make a shift in your thinking when it comes to back pain, I want you to think of it in the same way you think of pain when you get burnt or cut yourself. We know the extreme importance of pain when we touch a hot stove, it makes us snap our hand back, we do this because we are causing damage and the body is protecting itself. The same goes for cuts, extreme cold and even excess pressure. So why on earth do we suddenly think that back pain is different? Perhaps its because we can’t see the damage? Or maybe its because its not too bad right now. Either way its largely ignored until its not possible to ignore and its at this point we decide to simply turn off the fire alarm with some medication.
The reality of back pain is that when we get it, our body is telling us that something is wrong, we are in some way causing damage to our bodies and we need to stop doing whatever it is we are doing. Of course just what you are doing that is causing the back pain may vary greatly. For many the pain is caused, at least in part by leading a largely sedentary lifestyle, sitting in front of a computer all day, and then going home to watch Netflix on the couch until we fall asleep. For others it might be poor lifting patterns in a physically demanding job, and for others it may be poor functional movements that have developed due to a prior injury. Regardless of how the pain started, the best thing one can do is actively work at fixing the problem(putting out the fire). I continue to implore my patients and anyone else I run into with back pain to please not leave it until later, its always easiest to put out while its still just a small fire.