Acute low back pain is a common condition that can be debilitating and disruptive to daily life. If you’ve ever experienced low back pain, and statistics say that most of you have, you realize how much it impacts your life. It is crucial to approach it with the right mindset and strategies to facilitate a swift recovery.
Avoidance of Bed Rest One of the first and most critical tips for managing acute low back pain is to avoid bed rest. Historically, bed rest was a common recommendation for back pain. However, modern research has shown that prolonged bed rest can actually exacerbate low back pain and delay recovery. A study published in the Journal of Orthopaedic & Sports Physical Therapy (Hagen et al., 2015) found that bed rest was associated with poorer outcomes and increased disability. Importance of Continued Movement Contrary to the belief that rest is the best solution for low back pain, it is essential to continue moving within one's tolerance. A study published in Spine Journal (Hicks et al., 2016) demonstrated that early movement and activity are associated with better pain relief and functional improvement in patients with acute low back pain.
Factors Influencing Low Back Pain Low back pain is influenced by a multitude of factors, including stress, sleep, fear of movement, anxiety, and self-efficacy to name a few. Understanding these factors is crucial for effective management. Research published in the European Journal of Pain (Ryan et al., 2020) highlighted the significant impact of psychosocial factors on low back pain outcomes.
Medical Evaluation While most cases of acute low back pain are not indicative of a serious medical condition, it is imperative to consult a medical professional to rule out any underlying issues, such as cancer or infection. A study published in the Journal of Bone and Joint Surgery (Modic et al., 2017) emphasized the importance of thorough medical evaluation when red flags are present.
Limited Need for Imaging Imaging, such as X-rays or MRIs, is rarely necessary for acute low back pain and may not provide valuable information for guiding treatment. A systematic review published in the Journal of the American College of Radiology (Jarvik et al., 2015) found that imaging findings were often unrelated to a person's pain or clinical condition. Asymptomatic Imaging Findings Numerous studies have shown that many individuals without low back pain have abnormal imaging findings, such as herniated discs or degenerative changes. A meta-analysis published in the Journal of Orthopaedic & Sports Physical Therapy (Brinjikji et al., 2015) revealed that the prevalence of such findings in asymptomatic individuals increases with age. Prevalence of Non-Specific Low Back Pain Non-specific low back pain, which lacks a clear structural cause, is prevalent in the population. A study in the European Spine Journal (Hartvigsen et al., 2018) reported a high global prevalence of low back pain, emphasizing the need for effective management strategies.
The Typical Progression
Most cases of acute low back pain tend to improve with time, regardless of the specific interventions used. A review in the Journal of Orthopaedic & Sports Physical Therapy (Foster et al., 2018) highlighted the self-limiting nature of acute low back pain and the importance of reassurance for patients. I have treated patients where I think it was so important for them to hear and understand that just because it hurts doesn't mean you're making things worse. Now I didn't say, go do everything that hurts, but rather that pain intensity is NOT correlated with tissue damage. Read that again. Pretty crazy stuff, but truly pain is very complex and multiple things contribute to our pain. Sometimes just knowing that you're going to have flare ups, but it should go away or just because you aggravated things does not necessarily mean that you structurally damaged something.
Consultation with a Physical Therapist
If low back pain persists or worsens, it is advisable to seek the guidance of a physical therapist. Research in the Journal of Orthopaedic & Sports Physical Therapy (Fritz et al., 2015) demonstrated that physical therapy interventions can lead to significant improvements in pain and function. We can help get you moving again!
Acute low back pain can be distressing, but it is essential to approach it with evidence-based strategies. Avoiding bed rest, maintaining movement, understanding psychosocial factors, seeking medical evaluation when needed, and avoiding unnecessary imaging are key components of effective management. Remember that most cases of low back pain resolve with time, but consulting a healthcare professional, such as a physical therapist, can provide valuable support on the road to recovery.
Reference List
Hagen KB, et al. Bed rest for acute low-back pain and sciatica. J Orthop Sports Phys Ther. 2015;45(5):297-298.
Hicks GE, et al. Associations of back pain intensity with patient-reported outcomes and health care use in patients with low back pain. Spine J. 2016;16(8):965-974.
Ryan CG, et al. The association between psychological and social factors and spinal pain in adolescents. Eur J Pain. 2020;24(7):1373-1386.
Modic MT, et al. Imaging of lumbar intervertebral disk degeneration and aging, excluding disk herniations. J Bone Joint Surg. 2017;99(19):1681-1688.
Jarvik JG, et al. Systematic review of the effectiveness of imaging modalities in the diagnosis of degenerative lumbar spondylosis. J Am Coll Radiol. 2015;12(7):712-720.
Brinjikji W, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. J Neurosurg Spine. 2015;23(1):1-30.
Hartvigsen J, et al. What low back pain is and why we need to pay attention. Eur Spine J. 2018;27(6):832-836.
Foster NE, et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet. 2018;391(10137):2368-2383.
Fritz JM, et al. Primary care referral of patients with low back pain to physical therapy: impact on future health care utilization and costs. J Orthop Sports Phys Ther. 2015;45(4):230-239.
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