Decades of back pain is preventable

It is a disturbing fact that most people who get a bout of back pain go on to get it year after year. A recent study(1) found that four out of five people had episodes of back pain over 20 years later. This is especially concerning because they had attended their GP initially and this had obviously failed to bring them long term relief.

There were other factors which were also looked at to see if they could be the cause of this long term pain. The severity of the pain as well the clinical signs and work history were examined to see if these were likely to upset back problems. Interestingly only how hard individuals perceived they worked seemed to have a negative influence on the pain two decades later.

Why do back problems become long-term?

It is likely that most long-term back problems are caused by many factors. Some, like work-related stress, can play a key role but probably the single most important influence over the past few decades has been poor initial treatment. In his 1999 book The Back Pain Revolution, Dr Gordon Waddell described how “the medical model of back pain was inadequate for evaluating and treating many patients.” He showed how bed rest and pain-killers, the mainstay of treatment at the time actually contributed to more back pain.

Things have improved since then. Bed rest is not routinely prescribed anymore; exercise and encouragement to stay active are recommended by the NICE guidelines and most GP’s, if not all, are aware of these recommendations. Pain-killers and anti-inflammatory drugs are still also recommended although the incidence of serious side-effects can be a concern.

But it is not all good news for back sufferers though. The recent well-publicised increases in NHS waiting times are likely to delay prompt treatment for back pain. Physiotherapy departments are being stretched more and more and the waiting times rarely approached the recommended maximum wait of 6 weeks even at the best of times. Few physiotherapy departments employ specialist manipulative physio’s, fewer still an osteopath or chiropractor, in spite of this being a key recommendation of the NICE guidelines. This means patients are still being denied the best care.

How to prevent long-term back pain

There are some simple guidelines to prevent a bit of backache becoming an ongoing, recurrent disabling problem. Put simply it is not to ignore it. All the evidence is that back pain tends to keep coming back if the underlying causes are not dealt with. Most simple low back pain is caused by a combination of stiffness in the spinal joints, often brought on by poor posture. Poor trunk muscle conditioning also leads to spinal joint damage. So the simple solution to prevent chronic back trouble is:-

• get the stiff joints unlocked by a chiropractor
• do regular trunk muscle exercises for core stability
• watch you posture whilst lifting, sitting and other daily activities

If back problems keep on recurring or an episode lasts more than a few days you might need help from us to get back to normal activities. If you are unsure then we offer a free initial check to see if you have a problem that may be helped by our chiropractors or physiotherapists.

(1)

Early predictors of the long-term outcome of low back pain—results of a 22-year prospective cohort study