What is the best treatment for back pain?

Back pain is a huge industry. If having an entire profession nearly entirely dedicated to treating one body part isn’t enough as evidence (chiropractors), take the $100 billion in spending that happens each year into consideration. More people are affected each year and the cost is rising. So isn’t it crazy to think that research has found the best way to treat back pain and that it’s largely ignored? Not a day goes by that I don’t encounter someone who was given the option of “surgery or bust” without any referral to Physical Therapy. There are 18 states with unrestricted access to physical therapy, meaning you do not need a referral;  in these states patients can seek help without a referral (although your insurance company may require one).

Back pain book

Six fantastic tips for getting ahead of back pain.

It’s a tough blow to think that so many people haven’t been given the option to heal conservatively, do you wonder why that is? Without getting too far off topic, my suspicions are that the surgeons who do not recommend PT may have tried recommending PT at one point and perhaps it was unsuccessful due to the current high-volume PT model, and this may have shaped their sentiments into believing that all PT is the same. This is a shame, especially since with the right PT intervention, boatloads of time and money can be saved all while getting the patient back to the life that’s important to them.

  • Time: Check out this graphic from a study published by the Harvard business review. It depicts the traditional approach to low back pain vs. going to physical therapy first.   

https://hbr.org/2015/07/the-employer-led-health-care-revolution

This study demonstrates that with traditional approach to healthcare nearly 2.5x the amount of time passes before the patient is on their way to getting better! If going to PT first does not resolve the issue then the patient is able to be referred to imaging and a specialist anyway without losing much time. With what we know about chronic injury, the longer a tissue is injured the more unhealthy it becomes. Also, we as humans are adaptable; the more time we spend injured, the more bad movement patterns we adopt to avoid the pain. These movement patterns can lead to problems in the future.

  • Cost: The invention of the MRI was a great stride in medicine. Advanced imaging is fantastic for many conditions, however it is widely overused to diagnose orthopedic conditions. A good PT who uses their physical tests wisely should be able to tell you much of what and MRI will tell you. However what an MRI will not tell you, is if your back pain is caused by the way you squat, deadlift, or golf. The image is static, it does not move, and it only tells you which tissues may be stressed. It can be a great tool as an addition to a movement analysis and treatment plan but is not necessary unless there is concern of a more serious pathology. By choosing PT first, it has been found that thousands of dollars can be saved.

As if cost and time weren’t enough, there have been studies with patients who had no pain or minimal pain. These individuals went through an MRI which showed some degenerative changes (join the club) and then they started to develop pain or discomfort. You’ve heard of the placebo effect? It works the other way as well, the brain is a powerful tool and we need to be aware of that.

In summary, what should you do about low back pain? Seek PT first, it’s absolutely the best way to treat back pain! If you’re lucky enough to live in a state like Arizona you have direct access to physical therapists. There are 18 states with unlimited direct access and 26 states with limited direct access. 

Physical Therapy can save you time, money, and get you back to life quickly. That being said, not all physical therapy is the same. Be sure to research your PT and make sure that you are getting good care. See our blog on how to choose the right PT.  If you’d like to see if you would be a good fit for DPT give us a call or fill out our contact form. We help active people stay active every single day and would be thrilled to help you get back to your life.

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