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Low back pain? Try to stay active

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The best way to deal with occasional low back pain is to stay as active as possible, according to a new study published in The Lancet.

The research — part of a series of three papers on low back pain featured in the medical journal — challenges the assumption that it’s best to take pain relievers and stay in bed.

Instead, the findings suggest doing the opposite: stay as active as possible and, if needed, get advice from a health professional to help you get moving.

“The spine needs movement,” explained Doug Gross, a professor in the Faculty of Rehabilitation Medicine at the University of Alberta.

For decades, patients were advised to rest in bed, take pain relievers, and then consider diagnostic imaging and surgical options if that didn’t work. However, those recommendations have become outdated, Gross argued.

“Historically, we tended to medicalise back pain,” he said. “We’ve been conditioned to think that pain is always caused by something serious or catastrophic that needs rest or immobilisation, but most back pain gets better on its own with appropriate activity and movement.”

Back pain is a growing public health concern around the world, with cases more than doubling since 1990.

The problem is forcing a rethink of traditional medical treatments that increase healthcare costs but offer little benefit to patients, the University of Alberta said.

“Medical and pharmacological interventions are no longer the first line of recommended treatment. They won’t reduce low-back-pain disability or its long-term consequences,” said Gross. “There are also adverse effects from unnecessary surgery or drugs like opioids.”

At the same time, medical imaging is often ineffective. That’s because it’s rare for a specific cause of back pain to be identified, and it could provide misleading information from age-related changes that are common even in people without pain.

Over-the-counter and prescription medications also offer only limited benefits and should be a secondary treatment, the study showed.

It’s worth remembering that about 80% of new cases of back pain resolve on their own within two weeks.

“Pain drives fear, and it leads us to stop being active. Back pain can be awful, but expect that it will get better,” Gross advised.

If lower back pain is still debilitating after a few days, worsens, comes with other symptoms or lingers for more than two or three weeks, get checked out and seek advice from a healthcare professional on how to stay active. If needed, you can also get help to cope with the pain.

For pain lasting less than six weeks, the researchers recommend hands-on physiotherapy, massage and other manual therapies. Heat or over-the-counter anti-inflammatories can also help.

“The goal is to help you get moving, but none are a cure on their own,” Gross said.

And while strenuous exercise isn’t recommended in early stages, an exercise programme should begin as soon as possible.

For pain lasting longer than six weeks, recommended treatments also include exercise, yoga or psychological treatments to help overcome fear and anxiety.

https://www.folio.ca/dont-take-back-pain-lying-down

http://www.thelancet.com/series/low-back-pain

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30489-6/fulltext