Treatments for Back Pain
Brad Walker compares and contrasts what is known as traditional treatments vs complementary or alternative therapies for back pain.
When Dorothy followed the yellow brick road, she was told to do so by those who wanted her to get where she wanted to go. As humans, we often blindly follow recommendations by individuals who have good intentions but may not always be our best option.
Remember, there is rarely only one reason for your back pain and seldom one silver bullet fix. You may need to try several approaches to find what works for you.
When reading this article and thinking back on your visits to medical professionals, did you have the big picture, or were you following that yellow brick road? If you have been down that road, or if you are just starting to suffer from back pain it is never too late to seek out new and more encompassing information about your condition when trying to find a solution that works for you. Do not say you have tried everything because you have not; your answer is out there, and you have to find it!
One of the first places many people go when they experience back pain is the orthopaedic specialist (surgeon) and a visit usually lasts 5-10 minutes. They will typically look at the problem/symptomatic area and often fail to look at the body as a whole. If you have been to an orthopaedic specialist for your back pain, did they do a full-body physical evaluation (takes 30 minutes or more)? Not likely. Here are some of the conventional treatments used/prescribed by orthopaedic specialists:
Cortisone is a catabolic steroid intended to reduce inflammation by killing off the tissue in the inflamed area. Now let me ask you, does that make any sense to you at all? Not only are these injections quite painful, but they rarely result in any pain relief, and if they do, it is short-lived, usually 1-2 weeks, if at all. Plus, it does NOTHING to identify or address the cause of the pain... it is only intended to treat the symptom. It is for those reasons that we do not recommend them.
Just the name should scare you away. Just like cortisone shots, anti-inflammatory medications do not identify or address the cause of your pain, and for many people, they deliver little pain relief. These medications also produce serious side effects! The main reason they are prescribed is money and if you do not believe me, do the research, and you will see for yourself. The drug industry is vast, and unfortunately, they significantly influence the whole medical community, including the doctors. I challenge you to find a drug that will fix your back problem you will be looking for forever because there is no way a medication can fix a physical problem, so avoid medications at all costs!
Surgery for back pain is very conventional, and more often than not, the individual still has pain afterwards (or it returns within weeks) and sometimes even new problems! Very rarely is surgery the answer. For example, many people have surgery for herniated discs. The logic behind the surgery is if you remove the piece, or portion, of the disc that is putting pressure on the nerve, the problem is solved. Unfortunately, the same forces that forced that disc to protrude or bulge will likely move more of the disc out or another disc out. Surgery should always be the last resort, and I would question it even then!
Physical Therapy is traditionally the next step after seeing an Orthopaedic Doctor. That is, if surgery is not recommended. So, what should you expect? The process will start with an evaluation and maybe the start of the problem. Here is why the doctor has to prescribe with a diagnosis on it. You give the prescription to the PT, and they will perform an evaluation. Chances are, the PT will confirm the diagnosis from the doctor. However, the hope should be that they take the extra step to look for the root cause of your pain. They may, but chances are they have several other clients in the office simultaneously and do not have the time.
So, without a comprehensive evaluation to identify the root cause of your pain, they will treat your symptoms. We have just identified the second problem. The healthcare industry is required to show improvement with every session, so the push is to reduce your symptoms to show progress for them to get paid. The long and short of it is pain can be reduced, but the root cause rarely gets addressed, meaning that the pain and your suffering will return again and again.
So, what should you do?
When selecting a Physical Therapy office, you may want to ask how many patients the office sees in a day and how many PT's they have on staff. Then, ask how many patients a PT can work with within an hour. Do not be surprised to hear that a PT can see up to three patients in an hour. That is you and two others at the same time. Do you think you will get the attention and proper treatments you need? I doubt it.
There is a little joke in Physical Therapy when treating patients, and it has to do with what course of modalities you will get. The trick is called Shake and Bake, and it refers to everyone who receives the same treatment protocol. That way, it can be timed so that your PT can see other people simultaneously. What goes into a shake and bake treatment? It may start with a spin on a stationary bike or a trot on a treadmill. Then you will get a 3 to 5-minute Ultrasound over the affected area, followed by Electrical Stimulation to the area with a little Ice strapped to your body, and to finish off your session you will get a handout with exercises you should do at home. Certainly not a recipe for success!
One of the most common treatments for back pain is Chiropractic Care. The approach consists of physical manipulations of bones and joints to line things back up, and it is recommended typically 2 to 3 times per week. The problem with this approach is that the same forces (muscles, tendons, and ligaments) will likely pull the bones and joints right back out of place again. Also, most (not all) chiropractors will spend 15 minutes with you if you are lucky. Ask people who see a chiropractor how long they have been going. I hear of people who have been going for 10 to 15 years and still do not have a healthy back. Look, the fact is chiropractic care is lacking. Unless the chiropractor combines the two approaches, it does not make sense.
The ONLY way chiropractic care makes sense is if you are addressing the muscle imbalances that are pulling the bones and joints out of place, to begin with. That requires strengthening and stretching exercises that are chosen specifically to correct your muscle imbalances.
Massage therapy, if done correctly, can work wonders for people with back pain. This is not to say that it is the best choice and that it will work for everyone. However, most people will get great results from it if the massage therapist understands muscle imbalances and how to work on them.
NOTE: Not all massage therapists are the same! Like in any profession, there are varying degrees of training and qualifications. When selecting a massage therapist, please check if they are licensed and insured in the state where you will be seeing them. You should also ask the massage therapist if they have training in the following areas: Orthopaedic massage, Medical massage, St. Johns technique and have a comprehensive knowledge of muscle imbalances relating to back pain.
With that said, the benefits are as follows. The root cause will be identified, your discomfort will be addressed, and the root cause will be corrected, all in an attempt to make you pain-free and give you the tools you need to keep you that way.
What can you expect when you see a massage therapist?
All massage sessions are one-on-one, allowing you the opportunity to converse with the therapist and get the attention you need to get results. You can ask questions about how you compare to other people. Feel free to ask the therapist what approach will be taken to know what to expect. The massage therapist has many different techniques when dealing with your back pain, and some are better than others. Sometimes, a therapist can get distracted with other problem areas on the downside. Keeping them focused on your back and associated problem areas is in your best interest. Like anything else, you may need to try several different therapists before finding the one that works best for you and with you.
Post-rehabilitation fitness training
Another overlooked form of treatment that is very effective is post-rehabilitation fitness training. This includes targeted strength and flexibility work to correct and improve the individual's muscle imbalances. Certified post-rehab fitness trainers can only perform this service, and there are limitations to what they can do for you. For example, they cannot diagnose a condition, prescribe any medications, take x-rays, etc. However, if they are well trained, they can pinpoint your muscle imbalances quickly and get you started on a fitness program that will restore balance to your body and likely eliminate your back pain. Often this can be combined with massage therapy and/or manual physical therapy for a total solution. If you decide to go this route, which I recommend you do, thoroughly check out the fitness trainer and ask to see their certification, insurance, references, etc.
Manual physical (muscle) therapy
Manual physical therapy is NOT the same as regular physical therapy. There are some significant differences and here are just a few:
So, before you say, "I have already tried physical therapy", did you try manual physical therapy? They are two very different treatment approaches, and I highly recommend you consider manual physical therapy.
As you can see, traditional treatments are the mainstay of modern medicine not necessarily for the patient's benefit, but it is just how the system works best for itself. The system will not change until the system is confronted with a very powerful competitive force. That force may well be complementary or alternative care from Personal Trainers, Massage Therapists, Manual Physical Therapists, and the like.
The traditional treatments that people have been receiving for decades do not work, and we have found a combination approach that not only works the best but it is safe, natural, and inexpensive. If you have tried other treatments with little or no relief/improvement, you owe it to yourself to try this approach to take charge of your health and get started now working towards not only a pain-free back but a healthy and balanced body!
Only you can fix your back. All you need is the right approach!
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About the Author
Brad Walker is a prominent Australian sports trainer with over 15 years of experience in the health and fitness industry. Brad is a Health Science graduate of the University of New England and has postgraduate accreditations in athletics, swimming, and triathlon coaching. He also works with elite level and world champion athletes and lectures for Sports Medicine Australia on injury prevention.