Back Pain? What to Do, What to Avoid
Back Pain? What to Do, What to Avoid
Do you have back pain?
First, I am so sorry – and I hope you are feeling better soon. But don’t feel alone, more than 84% of Americans will at some point experience back pain.
Second, here’s the latest evidence on what to do and what to avoid for back pain.
Did you know that back pain can come from or be related to sciatica, sacroiliac joint pain, pelvic pain, reproductive or urinary issues, and a host of other concerns. A physical therapist is trained to evaluate multiple systems to help you manage your back pain according to the latest scientific evidence.
But despite established clinical guidelines supporting the early use of physical therapy in best care practices for the management of low back pain, physical therapy referral remains unchanged since 1990. The PT referral rate from a recent 11 year study at Beth Israel Hospital was a low 20%.1
What was startling about the study was that while narcotic prescription, referrals for diagnostic tests, and other physician referrals all increased, patient quality of care and back pain outcomes decreased. This latest study is not the first to reveal the discordant care of low back pain in America today. (2,3) This means that relying on diagnostic tests and drugs is not helping manage back pain. In fact, it can make it worse.
Additionally, PT is supported as the standard of clinical care for typical low back pain management. Yet, doctors are not referring to physical therapy often enough, nor are they familiar with what physical therapists actually do to evaluate and manage low back pain. It becomes difficult for a doctor to refer to another specialist, like physical therapy, when they are not aware of exactly what it is they do.
Most times, you as a patient have to speak up and ask for physical therapy. You can also call your insurance company and ask if you have direct access to PT. All 50 states now have direct access to PT like any other specialist. However, your insurance company may limit your access in order to keep their costs down.
What’s more is PT, when combined with yoga intervention, can address comorbidities known to directly affect low back pain outcomes (like depression, anxiety, and systemic inflammation), making integrative medicine a perfect adjunct to the clinically supported standard of care for low back pain.4
You have many options in front of you as a patient of physical therapy. Conservative treatment that costs less, and is supported by the evidence to be the “go-to” for back pain care. Physical therapy can also help prevent future episodes of back pain and prescribe customized exercise programs that fit your needs, which makes a few trips to your local, friendly physical therapist even more worth your time.
Sources
- Mafi JN, McCarthy EP, Davis RB, Landon BE. Worsening Trends in the Management and Treatment of Back Pain. JAMA Intern Med. 2013;():-. doi:10.1001/jamainternmed.2013.8992
- Carey, T MD, MPH; Freburger JK PT, PhD; Holmes GM PhD; Castel, L PhD; Darter Jane BS; Aganst R. PhD; Kalsbeek W. PhD; Jackman Anne MSW. A Long Way To Go: Practice Patterns and Evidence in Chronic Low Back Pain Care. Spine. 1 April 2009 – Volume 34 – Issue 7; pp 718-724.
- Fritz, Julie M. PT, PhD, ATC; Childs, John D. PT, PhD; Wainner, Robert S. PT, PhD; Flynn, Timothy W. PT, PhD. Primary Care Referral of Patients with Low Back Pain to Physical Therapy: Impact on Future Healthcare Utilization and Costs. Spine: POST ACCEPTANCE, 18 May 2012. doi: 10.1097/BRS.0b013e31825d32f5
- Gothe N, Pontifex MB, Hillman C, and McAuley E. The Acute Effects of Yoga on Executive Function. Journal of Physical Activity and Health. 2013 10; 488-495.
