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The reality is that 80% of us experience low back pain at one time or another in our lives. Behind the common cold, low back pain is the second most common condition seen by primary care physicians.
The pain and disability we experience can vary and frequently leads to time off work, loss of productivity, and chronic pain. Direct costs have been estimated to be $26 billion dollars and indirect costs up to $90 billion per year which is approximately one percent of our Gross Domestic Product. There is no denying that low back pain is a big ... and expensive problem.
There are many things that can be done to alleviate low back pain. After a medical screening, a whole body evaluation will identify problem areas. A whole body evaluation looks at the body from head to toe because, as the saying goes, the parts of our bodies are “all connected” and one area influences another. For example, abnormal foot mechanics or hip tightness, which are conditions found in a high percentage of the population, will contribute to stress in other places such as the lower back.
There are many causes of low-back pain. Research is showing that the pathology itself has little to do with the pain and disability people suffer. A static and dynamic assessment of the body is essential in order to get a complete picture: Poor posture, lack of strength and flexibility; the imbalance of strength and body mechanics, poor overall fitness, and the amount of stress on the body caused by a person’s daily activities, are all factors which can contribute to an episode of acute back pain.
Qualified health fitness professionals can help conduct screenings to determine exactly where your health and fitness levels are now. The best method to determine the optimal approach to low back pain is to classify it. Classification will match people with the most beneficial treatment. There are four interventions supported by evidence as treatments for low back pain: manipulation, directional exercise, stabilization/strengthening, and traction.
Manipulation has the highest success rate for those who meet the criteria. Ninety-one percent of patients treated with manipulation have dramatic success. One of the most important factors in having a favorable outcome is seeking treatment as soon as possible. The risks associated with harm due to manipulation are almost negligible. In fact, they are 1 in 10 million and safer than the potential complications of medications or surgery. Research has shown that receiving treatment within 16 days after the initial onset will yield the best results. There are also physical factors to consider - range of motion in the hips and whether there are symptoms below the knee. There are clinical practice guidelines which help to predict whether an individual will respond to treatment. These guidelines are increasingly being used in healthcare to avoid inefficiencies in time, money and care variations. Patients seeking out physical therapists should look for practices that use practice guidelines in combination with valid and reliable outcome measures to track successes.
For fitness prescriptions, the American College of Sports Medicine and the American Heart Association have recently spelled out basic exercise guidelines for individuals both under and over age 65. They addressed aerobic activity, muscle strengthening, flexibility, and balance. For more information on this report, visit www.acsm.org.
In summary, getting fit through strength, flexibility, aerobic exercise, and balance will help decrease the likelihood of having an episode of low-back pain – especially chronic or disabling back pain, which may cause unnecessary suffering and loss of time from work. If you do experience low-back pain, the greatest success comes when you seek treatment quickly by qualified professionals who look at the body as a whole. Recognize the big picture with respect to your activities and goals. See your physical therapist directly for a consult or a qualified personal trainer for a health fitness screening.
Lance Knaub DPT, OCS, CSCS
President/Owner BREAKTHRU Physical Therapy & Fitness
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