It’s two of my favorite questions to ask new patients with back pain:
How long has this been going on?
And: What have you done to take care of this before now?
The answers are often the same, but still surprising: “Far too long”, and “Nothing”, respectively. Pain can sometimes be easy to ignore… until it just can’t be ignored any longer.
The Top 5
As a practicing PT for over 10 years, I’ve heard so many different things from patients as to why they delay treatment. You may find yourself in these Top 5 excuses patients have given for not seeking care:
– It’ll just go away
– It’s not that bad
– The doctor will just give me pills
– The doctor will want to do surgery
– I saw a Chiro/PT before, and it didn’t work
Do any of these sound like you? In my experience, I can almost certainly say that these are all not likely.
Do Nothing, Get Nothing
Why do we do nothing? The reasons are varied, but all valid. Maybe it’s really not that bad. Some people think that it will be too expensive and time consuming to address it. Perhaps you’ve had a doctor just give you some pills and sent you on your way. Or perhaps she or he started talking about needles or surgery. Prior treatment didn’t work, you’ve heard your friend’s horror stories, and the magic of the Internet has dashed all of your hopes. So you’ve decided to just “wait it out”, hoping that it will resolve by itself. But it hasn’t.
However, have you considered what it costs to NOT have it addressed? How much are you spending on ibuprofen every month? Are you still paying for a gym membership, but not using it? Is it costing you time with your family or friends? While medications, injections and surgery are all options, what if there were other, non-invasive options? And if other PT wasn’t successful before, there may be some reasons why. Either way, it’s probably obvious by now that the “do nothing” strategy probably isn’t working too well. Doing nothing about your back pain, as a long-term strategy, will get you nothing.
In A Rut
Research shows that people in pain change how they move. It’s called Compensation. We do things and move in ways to avoid pain. But doing so removes some of our “options for movement”. If the main road (or train line) you use to get to work every day was shut down, could you still get to your destination? Hopefully you know some alternate routes! Getting stuck in those compensations creates a movement “rut”. Just like a dirt road that was recently muddy, deep tire tracks that are now dried up offer few options: your tires are going to go in those grooves. But for you to get better, you’ve got to get out of that rut and restore your movement options. And just because the pain is gone, it doesn’t mean that the compensations are gone, too!
Not Out Of The Woods
So, maybe the pain has resolved. This might even be a regular cycle for you, as I’ve heard from a number of patients that “My back goes out 2-3 times a year… for the past 10 years”. But just because you’re not experiencing pain right now does not mean that you’re out of the woods – especially if this is a pattern for you. Restoring your mobility is important. And it’s important to look everywhere for mobility restrictions. Remember that sprained ankle from 3 months ago that you rather forgot about? Could be a culprit.
Research has also shown that important stabilizing muscles along our spine do not spontaneously recover in the absence of pain. Read that again: just because there’s no pain doesn’t mean that everything works the way that it should. But quite often, people go back to their daily life and exercise routines because the pain is gone. Your body needs to “go back to school” to be reminded of it’s original purpose and refresh those stability strategies before you move on to the bigger stuff.
The Crimes We Commit Against Ourselves
There’s an old cartoon where a man says “Doc, it hurts when I do THIS.” To which, the Doctor says “Then don’t do that”. It’s actually simple, sound medical advice. Getting to the bottom of what might be causing your pain sometimes reveals that it’s the things we enjoy doing that are actually causing pain. But don’t fret: that doesn’t mean that it’s off the table for good. Those things become what we call Goals! But do you really know what activities or movements are perpetuating your pain?
So, What Now?
The next step to feeling better is to find a healthcare team that understands you and your goals. Our current healthcare landscape is more in the hands of the Consumer than ever before. Your physical therapist should help you get to the root cause of your pain, have time to work with you 1:1, and develop a clear path forward with you. With a clear plan of attack in hand, you stand a better chance of a more complete recovery, a smarter approach to returning to activities, and are less likely to re-injure yourself.
Help Is On The Way
You need to be strong for your life. If back pain is keeping you from training in the box, sitting at work, or if it’s painful to even carry your groceries home, help is on the way. For those that need instant gratification, try the tips in our free back guide, The Back Pain Fix (Go to back.mvmtpt.com), and start feeling better today. We’re also excited to discuss the different options at MVMT to work with our therapist, get to the source of your back pain, and get you back to doing the things you love. Simply call us at (646) 430-5717, or email us at email@example.com.
Mark M Lusk, DPT, OCS, CSCS, CFMT