Simplifying the treatment and management for low back pain

Simplifying the treatment and management for low back pain

The chances are you will have experienced an episode of low back pain at least once in your life.  You’ve probably experienced it many times.  Low back pain is one of the most normal things a human can experience.  It’s estimated in some studies that over 80% of people will get an episode of back pain at least once every 2 years.  The global burden for spinal pain results in more disability, functional losses and loss of work than conditions like diabetes or cancer.  The actual burden of spinal pain is increasing every decade!  This can be seen in this very busy looking but informative chart.

Charts of Leading Causes in 1990, 2005, and 2015

I often present this chart in the courses I teach and I ask participants this question, “why do you think low back and neck pain has moved up from the 12th largest burden of disease to the 4th in 25 years?”  To clarify, I don’t like thinking of spinal pain as a disease.  By definition, spinal pain could be a disease, “a disorder of structure or function in a human, animal, or plant, especially one that produces specific signs or symptoms or that affects a specific location and is not simply a direct result of physical injury.”  However, when people think of a disease, they envision an invading pathogen, tumour, heart disease or an autoimmune condition.  By labelling back pain, a very normal occurrence in all humans, as a disease it may lead to further pathological thinking.  How we think shapes our communication and influences how we act.  Words matter, and they matter a lot! Therefore, when we are discussing spinal pain we should be mindful of how we communicate and the influence this could have on patient and societal attitudes.

Some of the most common responses I get from my question above are; humans are more sedentary, they sit at computers, are overweight, or experiencing higher stress levels now. These things will play a role, but I don’t think they are the most important factors to consider.  I think a bigger problem with spinal and neck pain is that as a society we have made it something that people should fear.  People think they shouldn’t have pain, or if they do there must be something structurally wrong that needs to be fixed.  To make this matter worse, let’s pause f