Accessibility Tools

Skip to main content

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/

 

Athletes Do Not Need Balance to Be Successful

In the attempt to improve athletic performance or prevent sports-related injuries, it is common to read that muscles in the body should be balanced. At times, what “balanced” means is never fully explained and is often assumed to mean that muscles on both sides of a joint should be equal in qualities such as endurance or strength. As a result, trainers and coaches may advise athletes to perform equal training for musculature on all sides of a joint to ensure balance.

The intent is to achieve symmetry. Not just at one particular joint, but often throughout the body. The goal is to see symmetrical movement on both sides of the body. Consider how therapists and coaches will use movement-screening systems to evaluate movement and then apply correctives with the goal to ‘balance’ the body or to reduce the risk of injury.

However, one must question if this the most intelligent thing to do in relation to high-level athletic performance. 
From the few studies done on this topic and from observation, symmetry may not be an effective means of improving performance. Rather, It appears that the majority of high-level athletes are asymmetrical.

This should not be surprising if you have been looking closely at high-level athletes. I recently attended the ACA Rehabilitation Symposium in Las Vegas over this past weekend. Professor Stuart McGill was one of the featured speakers and he has extensively researched the factors which make great athletes great. Professor McGill provided numerous examples from cases he has seen over of the years of athletes being ruined by someone attempting to 'balance' their body. The intent was on improving their performance or ‘correcting’ movement, yet the end result was making that athlete a patient. Essentially, he cautioned us all as chiropractors, therapists, and trainers to be very wise in what we do with our athletes.

One example he provided was Olympic sprinters and how many of them have very stiff, tight ankles. He stated how this is necessary for their performance and ultimately their success as elite level sprinters. Their ankles must be stiff to serve as ‘springs’ for explosive running. Yet, as he stated, many therapists would want to ‘mobilize’ their ankles and ‘release’ or ‘stretch’ the musculature surrounding the ankle to improve range of motion. However, now you have robbed them of the very thing that makes them a great athlete in their sport.

His example brought to mind a high school football player who trains at GP. He is our fastest athlete and his ankles are incredibly stiff. This stood out immediately upon his initial assessment. Did we do anything to mobilize his ankles? No. We didn’t touch his ankles, understanding that his ankle stiffness is what made him fast. Made him incredibly agile and quick.

If you try to balance muscular development or joint function, it can potentially interfere greatly with an athlete’s performance. It’s important to remember that what makes athletes asymmetrical also makes them great. It is not only a consequence of their training, but often what their sport demands. To take time out of their training to balance their body arguably interferes with more productive training.

This does not mean that they do not do exercises to keep their body healthy and prevent injury. We have our athletes perform many exercises for this purpose, but they are typically done during the general preparatory period, not in the competitive or precompetitive periods.

Former Soviet Union sport scientists studied this concept. The Soviets understood that asymmetry appears to be a key to athletic success. Asymmetry that is produced appears to allow athletes to go above and beyond what other ”well-balanced” athletes are capable of doing. It seems that the asymmetry allows the athlete to perform on a higher level.

There appears to be enough evidence to indicate that perhaps we should not be anxious to 'balance' every athlete’s physical development. Keep in mind that this does not mean that you ignore development of antagonistic muscles. But you do not emphasize them to the same extent as you do with the main muscles and joints involved in the execution of the athlete's competitive sports skill.

More related reading:

https://gallagherperformance.com/athletic-development-will-your-child-be-a-success-or-burn-out/

https://gallagherperformance.com/does-practice-make-permanent-how-practice-rewires-your-nervous-system/

https://gallagherperformance.com/commonmistakesindevelopingyoungathletes/