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THE MYTH ABOUT LOW BACK PAIN

The write-up is compiled by Dr Dolilur Rahman, Senior Consultant of Physiotherapy at Bangladesh Physiotherapy Hospital, Gulshan, Dhaka.

The prevalence of back pain has not changed, but unhelpful ideas about it have increased; for example, if you have got back pain, you have damaged your back; if your back hurts, don't move; and if you have got back pain, a disc is out of place.

Low back pain is one of the most disabling health condition across the world. Many people have been suffering back pain due to wrong treatment. It is very usual that if anyone of us suffers back pain we visit healthcare professionals to become better and get relief from sufferings.

Many patients complain that they feel worse after the treatments. Many back pain treatment options have been promoted over the years as different healthcare professionals but unfortunately these treatments were failure to solve the bad backs.

Fortunately 90% of people with acute LBP will have their pain resolve within 8 weeks, regardless of the type treatments they receive or not treated at all, 5% within 12 weeks.

But 70% of those who fully recover in 8 weeks can expect to experience progressive episodes of LBP in the future. Those who report a recent onset of back pain, half will have a recurrence of that pain within a year. It is unusual to have back pain only once in your life.

If the clinician does not explain low back pain correctly, then patients think there is something seriously wrong with their back. But research showing that 95% LBP is non-specific, although there are some common findings like osteo-arthritis, spondylosis, spinal canal stenosis, disc herniation in patients with low back pain but these also occur in asymptomatic people. Hence such conditions may not be the cause of the pain.

Professor Chris Maher, a leading medical researcher and director of the Musculoskeletal Division at the George Institute for Global Health, says,

"The treatment that is endorsed for acute back pain is quite simple, but patients get more complex care; they get more of the wrong sort of treatment."

It is showing that these traditional treatment approaches have been woefully ineffective at treating or preventing acute episode of low back pain

If you send people off for imaging they are more likely to end up being offered surgery," Maher says. "If you send them off for imaging, about a third will come back with something found."

Patients then focused on the imaging results and could become quite disabled by them.
But asymptomatic patients with no back pain have been found to have a high incidence of positive MRI findings.

A prospective study of Weber stated 280 patients with herniated discs.

The surgical group demonstrated a more rapid recovery than the non-operative group, at 4 years, however, the outcomes were roughly equivalent, and at 10 years there were no appreciable differences in outcome.

"Keep in mind to consider the risk and benefits of a treatment you may be offered. The only things that have been shown in research to work is giving people a specified exercise routine after the occurrence of back pain and a skilled and knowledge based experienced Physiotherapist can play a key role to prescribe and implement this specified exercise programme."

 


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