Is Imaging Helping or Hurting Your Low Back Pain?

Low back pain is an extremely common problem that over 75% of the population will experience at some point in their lives. If that does not make your day better, how does it make you feel to know that around 60% of people that don’t even have low back pain still have some sort of abnormality such as a bulging disc. Now I am not writing this blog to try and scare everyone into thinking they are doomed to a life of back pain and disability. This post is all about showing you that, contrary to popular belief, most of the time a “slipped” or better defined a bulging disc is not a death sentence for a lifetime of pain and also that having medical imaging done when it’s not necessary may actually cause more harm than help. Let’s first talk about how we need to stop blaming the discs in our low backs for all our pain. There certainly are times when the disc tears through its protective space and irritates nerves however, this is not as common as many people think. Many people are told they have a bulging disc and immediately start thinking of all the people around them that have had the same diagnosis and how it seems like they have low back pain forever. The good news is that according to the research a large amount of the population has a bulging disc without any low back pain meaning that you will be able to live your life without pain even if you have this bulging disc for the rest of your life. For individuals one of the biggest correlations with the development of chronic low back pain is about their thoughts towards their back pain. This is why it’s important for us all to understand that the abnormality you may see on a medical image is not always a life sentence of pain and disability. It’s crucial to know that much of the population have a similar abnormality with no symptoms which is great for helping people understand that they can get back to having no low back pain as long as they work for it. Helping people maintain a positive outlook on their back pain is one of the most important things that a physical therapist can do to help people relieve their back pain and help prevent it from becoming chronic. If you suffer from chronic back pain and have been told it’s a “slipped” or bulging disc be sure to talk to your physical therapist about how positive thinking about your back pain can help reduce your chances of having chronic pain and get you back to your daily living. Knowing that back pain has a lot to do with the thoughts a person has towards their back pain and that so many people have an abnormality with their discs in their back it’s important for us to use imaging wisely. Everyone has had the experience where they are going about their day with no problems and then you look at your finger, realize you have a papercut and then your entire day your finger stings and hurts because of that tiny papercut. In a similar way if you get imaging done and don’t have really bad back pain and then you see these slipped discs you are more likely to have fear of hurting your back more and be more aware of pain. This is why it’s so important that people need to delay getting any imaging done unless there is a concern for a more serious condition in the low back. Physical therapists play a crucial role in recognizing the signs that may indicate a need for imaging to be done. Physical therapists are able to diagnose most causes of low back pain without the need for imaging and treat it in a more conservative way. Another reason why people should consider their physical therapist first before going to the Emergency Department or urgent care for their back pain. If people go to their physical therapist first they are more likely to be treated in a more conservative way without having the panic of seeing some abnormalities that are more than likely to show up on their imaging. This not only decreases the risk of unnecessary fear from imaging, but also reduces costs to the health care system significantly. It’s time that we stop blaming all low back pain on bulging discs and start recognizing the value of physical therapists in evaluating, diagnosing, and treating low back pain. If you have any concerns about your low back pain call your physical therapist and find out more about the important role physical therapy can play in restoring your daily function.

You Hate Exercising...Now What?

How many times have you heard the general statement that people need to exercise or be more physically active and had the immediate thought of "but I hate running so much?" Many people are told that they need to get active and exercise and the first thought is about having to deal with the gym or running endlessly on a treadmill. I discussed earlier about the importance of exercise as medicine and how important it is to overall health but what if you don't love exercising? You are going to be told constantly by your physical therapist and other health care providers to exercise and get physically active. I think it's important to understand that exercise and being active is much more than just intense running and lifting weights at the gym. The current physical activity guidelines for a majority of the population is simply to do moderate intensity physical activity for 150 minutes a week or vigorous intensity exercise for at least 75 minutes a week. It is also encouraged that people should be physically active more days in the week than they are not. Moderate intensity physical activity can be simple things such as going for a walk or simple hike, an enjoyable bike ride, or even just getting out and playing with kids and grandkids. Vigorous intensity activity can include brisk walking or hard hiking, playing sports, or fast swimming. When it comes to being physically active people have so many options that they just need to find something they enjoy doing and incorporate it into their daily lives. Physical activity and exercise does not have to be a scary thing. It's crucial for us to find things we like doing which will make it more likely for people to actually follow the physical activity guidelines.There are certain populations that benefit from specific kinds of exercise based on their family history and current health status. For example, if you know you have a family history of osteoporosis and you want to do all you can to minimize your risk you should focus on exercises that require you to bear weight on your bones. Again, there are more options out there than just walking or running. What about taking a dance class which will not only impress the man or woman in your life, but also decrease your risk for osteoporosis while helping you meet the physical activity guidelines! What about people with chronic pain or Fibromyalgia where exercising is literally the last thing they want to do? Even though it may seem like exercise and activity makes things worse, physical activity is crucial and extremely beneficial for this population. For these individuals you can get up to the amount of physical activity that is recommended...it's just going to take time. Start by walking or doing yoga for 5 minutes and then slowly progress that each week until you are reaping the health benefits of activity. For everyone trying to figure out how to get started get in contact with a physical therapist who can get you started and give you ideas for the best physical activities that will work for you.