• John Randa

A Practical Approach to Low Back Pain


Low back pain. Everyone seems to have had it or know someone who struggles with it. It is so prevalent in fact, that some estimates place a $100 billion dollar cost of treating low back pain within the US (1). This fact was reported in 2009, I can’t imagine what the costs are 10 years later in 2019! Additionally, low back pain has been regarded as the top cause for activity limitations and work absence globally (2).

As the prevalence and costs seem to increase with low back pain, treatments continue to evolve. New procedures, injections, and surgeries are becoming more apparent despite their controversial results (3). Fortunately, physical therapy continues to be a mainstay. Physical therapy provides as a valuable non-invasive, low-cost treatment option compared to expensive and invasive surgeries. In fact, it has been reported that those who underwent PT for low back pain as their first treatment option incurred lower out-of-pocket, pharmacy, and outpatient costs for the following year and had a reduction in opioid use by 89% (4).


All facts aside, the key to managing and improving that stubborn back pain is to keep moving. Just threw out your back picking up something from the ground? Keep moving. Have had back pain for the past 10 years after slipping and falling? Keep moving. Our bodies were hardwired to move! Movement and exercise provide a powerful signal to your brain and nervous system to relax pain and prevent you from becoming immobile.


That being said, it is important to keep your movements as pain-free and non-provoking as possible. Just felt a twinge in your back? Relax and take a brief mental note of what caused it and keep moving forward. The more we tend to perseverate on your pain often the worse it gets!


With physical therapy, I love to use dry needling, massage, and mobility work to reduce my patient’s pain. However, from there, the most important intervention is to initiate a safe exercise program that encourages core/hip strengthening and movement throughout the entire body. This holistic approach manages the pain at hand and helps prevent nagging pain flare-ups in the future.


Have back pain? Want to learn how to move through it? Contact me!



Resources

1. Crow WT, Willis DR. Estimating cost of care for patients with acute low back pain: a retrospective review of patient records. J AM Osteopath Assoc. 2009 Apr;109(4): 229-33.

2. Kent PM, Keating JL. The epidemiology of low back pain in primary care. Chiropr Osteopat. 2005;13:13.

3. Atkinson L, Zacest A. Surgical management of low back pain. Med J Aust 2016: 204 (8): 299-300.

4. Frogner BK, Harwood K, Andrillla CHA, Schwartz M, Pines JM. Physical Therapy as the first point of care to treat low back pain: An instrumental variables approach to estimate impact on opioid prescription, health care utilization, and costs. Health Serv Res. 2018 Dec; 53(6):4629-4646.

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