Back pain is the scariest of all orthopedic surprises, especially when you wake up in the morning suddenly bent over.
Back injuries are typically muscular and are usually due to weak core muscles. They can often occur after lifting an object from an unusual position, which causes twisting and straining of the back muscles.
Sometimes back injuries are more dramatic, involving injuries to the disk or the ring around the disk called the annulus. Also, injuries can cause disk rupture or nerve impingement in the back. Back pain is one thing, but the fear that it won't ever go away is another. Both are scary and humbling, and unfortunately incredibly common.
According to the American Academy of Orthopedic Surgeons, 30 percent of Americans experience back pain on any given day and 80 percent of Americans will experience back problems at some time in their lives. This comes at a cost. The AAOS estimates that direct medical charges and lost productivity because of back pain add up to between $30 billion and $70 billion a year in the United States.
Many common treatments for back pain often leave the patient with unwelcome side effects: Anti-inflammatories address the symptoms but not the problem, narcotics and muscle relaxers make you nauseated and lethargic not to mention addicted, braces temporarily support you but weaken the muscles and bed rest weakens the entire body.
Chiropractic care, acupuncture and massage have all been shown to help but there is an argument to be made that they help primarily because someone spends 30 to 60 minutes with you focusing on the problem, independent of what is actually done.
Surgery is the last resort. Results vary from significant satisfaction for some to devastation for others. The risk assessment is often very difficult to make and so it is hard for you to know which group you will end up in, not because the surgeons aren't skillful but mostly because fixing one area of the spine often leads to problems in other areas.
In my experience over the years, the Nos. 1 and 2 best treatments for back pain of almost all types are to have a superb physical therapist who excels at manual therapy and then combine that with a lifelong fitness program focused on trunk and core strengthening.
Why? Because a superb physical therapy sees the whole body and works on correcting all the mechanics that either lead to or are a result of back pain. Physical therapy techniques are able to mobilize back injuries rapidly. Early motion and stretching, where the injured muscles are balanced against uninjured muscles that counter force and engagement, can often stop a back spasm earlier than if just rest is used.
Top physical therapists have manual skills that mobilize tense muscles and identify muscle weaknesses that even most Olympic-level athletes do not realize they have. In our practice, we are aggressive in using ice and anti-inflammatory medications as necessary in order to stop the immediate muscle spasm and pain.
We also have our patients do cross-training using swimming, careful weight training, Pilates, yoga and other back exercises in order to retrain the back and core muscles to diminish the recurrence of back injuries.
A top physical therapist can design a strengthening-exercise program customized to you combining all the tools to help you prevent recurrence of the back pain. An extremely strong trunk and core with great body mechanics is the key to a life without back pain.
So today, start fixing your back pain or preventing future back pain by a daily trunk-muscle strengthening program focused on the gluteal (butt) muscles, the abdominal muscles and the back muscles.
Vary the program and do it daily, seven days a week, until your posture is erect when sitting and standing, your belly is firm, your butt hard and your confidence to do the activities and sports of life as high as it has ever been.
Dr. Kevin R. Stone is an orthopedic surgeon at The Stone Clinic and chairman of the Stone Research Foundation in San Francisco. He pioneers advanced orthopedic surgical and rehabilitation techniques to repair, regenerate and replace damaged cartilage and ligaments. For more info, visit www.stoneclinic.com.