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Low Back Pain Treatments That Just Won't Help

Back pain was believed to be a self limiting condition for the majority of individuals, meaning that the nature of back pain is that it would "run its course" and eventually pain would go away on its own.  Current research has demonstrated that this understanding of back pain is flawed; yet many clinicians still hold this belief.

In fact, 85% of people with a single episode of low back pain will likely experience future recurrences and 2-8% of those individuals will develop chronic back pain.

Chronic pain accounts for 75% of all healthcare costs related to low back pain, is second only to the common cold in missed days from work, and is the number one reason for workmen compensation claims.

Considering the burden chronic back pain places on healthcare resources, patient management appears to be an issue in need of addressing appropriately as many patients find it difficult to find effective treatment.

Low Back Treatments That Don't Help
Now many experts are questioning the model in which back pain is treated as a growing body of research suggests many common back pain ‘cures’ just don’t work. These include:

  • Ultrasound
  • TENS machines
  • Strong opium-type painkillers, such as diamorphine
  • Spinal injections
  • Spinal fusion
  • Disc replacement
Prescribing drugs or cutting people open when you don't know what's causing the pain is very unlikely to be successful in the long term. Surgery should only be used as a very last resort. There is a significant lack of efficacy for many treatments, but the deeper issue here seems to be that many healthcare providers have difficulty in accurately identifying the cause of ‘non-specific low back pain’.

Top spine expert, Professor Stuart McGill is the world’s leading spinal biomechanics researcher and has identified common reasons for back pain and the importance of exercise as an intervention for effective treatment.

In Dr. McGill's opinion, based on over 30 years of research, every case of back pain has a cause and the reason many treatments are ineffective is because they are used on a one-size fits-all approach, rarely targeting the underlying problem.
There are many possible causes for back pain, but you must first find the positions and stresses that trigger pain. As Dr. McGill says, finding these positions and stressors allows the provider to formulate a precise diagnosis and a roadmap to recovery. This roadmap is guided exercises that can correct the harmful patterns and build a stable, firm spine.

Addressing Misconceptions
The importance of a firm spine can come as a surprise to many, as the common perception is that your back must be flexible in order to be healthy and pain-free.

The spine must be firm and have strong muscles surrounding it to help transmit forces from the legs and the shoulders while minimizing the stress on the spine. When the muscles of the spine aren’t strong enough, micro-movements can occur that eventually can sensitize the spine and lead to a painful back.

If you have some movements, which are comfortable to build on, this opens the door to conservative management and recovery through guided exercise

However, recommendation of exercise without a clear understanding of movement intolerances and muscles that must be strengthened can also be harmful

Guided Exercise: The #1 Intervention for Low Back Pain
Exercise is essential both to protect and repair your back, but simply hitting the gym or doing Pilates or yoga without knowing the movement patterns that are generating your pain or the ones that will protect and build a pain-free back, has little chance of being effective.

Thanks to exercises specifically targeted at a patient’s problems, we are able to help educate them on proper posture and movement so they do not put damaging load on their spine. The guided exercise model is truly about identifying a patient's underlying back pain generators and educating them on not only how they can get out pain, but also what they can do to keep it from returning.

When you consider that 85% of individuals who have low back pain will experience future recurrences, there must be a priority placed on educating patient's about proper posture, movement, and exercises that build a firm, strong spine. Guided exercises are showing clear efficacy for use in patients with low back pain and should be a staple in their treatment plan.

If you are suffering from low back pain, whatever the cause, consider Gallagher Performance for your evaluation and treatment. Our goal is to relieve your pain while teaching you what you can do to keep the pain from returning.

More related reading:

 
https://gallagherperformance.com/solution-long-term-improvement-back-pain/

 

The Benefits of Performance Therapy


For those of you that are familiar with Gallagher Performance, you understand the importance we place on the integration of our sports training, chiropractic, massage, and manual therapy services. We feel this model allows for optimizing sport-based outcomes while keeping our athletes healthy and ready-to-train. The model is not completely unique, as chiropractors, therapists, physical medicine providers, and strength/physical preparation coaches are collaborating in similar models to better serve their clients and athletes.

With that in mind, one frequently asked question we receive is,
"How are these services different from sports medicine care I can receive from a physical therapist or other specialist?"
The concept of what is commonly referred to as ‘Performance Therapy’ can be seen as a unique and completely separate approach from traditional sports medicine or physical therapy. To illustrate this, here's a quick look at a comparison of the mindset behind sports medicine and performance therapy.

Traditional Sports Medicine
  • Reactive approach to sports injuries
  • Therapy and rehabilitation focused
  • Emphasis placed on passive modalities, manual therapies, manipulation, therapeutic exercise
  • Tissue-specific
  • Patient-centered
  • Occasional focus placed on "injury prevention" strategies
  • Primary goal is the return to training or sport abilities prior to injury
Performance Therapy
  • Proactive approach between coach, athlete, and doctor/therapist
  • Focus is on mechanical efficiency for skill acquisition and motor learning
  • Continual "tweaking" to optimize performance
  • Manipulation and manual therapies used for facilitation, to enhance the process of building mechanical efficiency
  • Skill-specific
  • Athlete-centered
  • “Injury prevention” is a by-product of the process
  • Primary goal is to enhance sport performance
We are very fortunate to have a skilled and knowledgable team of therapists and coaches working at GP. The dynamic created between therapist and coach allows us to not only screen each client and athlete prior to all training programs, but to also carefully watch their movement during each training session. The goal is identify specific movement qualities that could potentially have a negative impact on sport-specific movements, the acquisition of new skills, or injury prevention methods. This approach continues throughout the duration of the training program and allows movement dysfunctions to be addressed before they lead to greater issues.

Performance therapy becomes not just about normalizing function or "returning to sport", but optimizing the function of the athlete and "enhancing performance". Therapeutic intervention (or "treatment") occurs as needed during training sessions. This can include the use of a variety of exercises to improve stability/mobility or techniques that activate the nervous system to improve movement coordination. Regardless of the intervention, the goal is for athlete to adapt and improve more quickly than if training and treatment were approached separately.

The transition between training and treatment must be seamless. When it comes to performance therapy, we have noticed the following goals are achieved:
  1. Greater Body Awareness. By integrating the appropriate intervention into the training plan, there is an effect on motor control that generates greater permanence on a neurological level. Basically meaning the athlete masters new movement skills faster. The instant feedback from treatment allows the athlete to provide the coach or therapist with an understanding as to how they feel/move during training. Coaching the athlete thus becomes more specific, allowing them to learn and improve quickly.
  2. Optimization of the Training Session.  Performance therapy integrated with training typically involves a lot of “tweaking” in order to meet the demands of the athlete. It provides the framework to keep athletes performing at their best more consistently. Several athletes receive some type of treatment or practice regeneration/recovery methods prior to competition. So why would they not receive similar interventions during an important training phase?  Both serve the same purpose to optimize performance.
  3. Improved Monitoring of the Athlete. Performance therapy provides additional information on the readiness of the athlete to train. Both the therapist and the coach use this information to make educated decisions regarding the details of each training session, allowing for true customization of your training plan. It’s important that athletes are monitored for how well they have recovered between training sessions so you know how hard to push them. Also, athletes tend to have the ability to 'hide' things very well. Being able to identify slight differences in muscle tightness or movement abnormalities not only will allow us to make better decisions about the training session, but also help prevent more serious matters such as injury or overtraining.
Keep in mind that performance therapy is not intended to create athletes who are dependent on this model, but rather athletes who are held more accountable in the pursuit of their own goals. The coach or therapist is provided with the information needed to recommend the most appropriate "homework" for the athlete, such as foam rolling specific muscles, mobility or stability drills, and the use of recovery methods. Furthermore, performance therapy is not intended to serve as a replacement for other forms of therapy. It is not simply moving the treatment room to the training room. Even though the goal of performance therapy is to reduce the amount of time spent on treatment and return to sport measures, there is a time and place for other medical and/or alternative interventions that should be understood and respected.

Closing Words
Both sports medicine and performance therapy are necessary components in the health and performance of athletes. Failure to integrate therapy in a complementary manner can be a mistake. Without performance therapy there tends to be an increase in reliance on other forms of therapy that stress rehabilitation and recovery.

In sports, the term "game changer" is often used to describe an athlete or action that results in a successful outcome that changes the course of a game. The same can be said about performance therapy because of its ability to play an invaluable role in an athlete's development. If you've been experiencing lack of results or just can't seem to stay healthy, performance therapy may just be the "game changer" you have been looking for to improve your abilities as an athlete and GP is where you can find it.