Spending over a decade in physical therapy, working with back pain and sciatica sufferers, we came to a conclusion, that lack of education on the topic, and absence of research-backed information on spinal health and its maintenance is a major part of the problem.
What struck us most about the entire situation was how strikingly helpless do otherwise strong people become, when the back pain strikes.
Videos online, and some ‘spinal guru’s’ workshop is all that people can rely on trying to avoid the unnecessary surgery. Videos are…just videos – usually it is just a collection of few exercises that “should relieve the back pain and stiffness when you feel it”. Although they may help some person by a pure chance, they will not produce consistent results. And the reason is: none of them offer a systematic solution for a specific painful spinal condition, which ‘drops’ the value of such help to a zero.
What about ‘mainstream healthcare’?
Mainstream healthcare – here are few things we know for sure:
- GP will only prescribe drugs, if that fails – you’ll be prescribed stronger drugs and advised to rest. When that fails you’ll get a prescription for opioid or codeine-based drugs, etc…
- When drugs don’ help at all, referral to get an MRI (magnetic resonance imaging). MRI can be ‘hit-or-miss’ (depending on the thickness of the ‘slice’) and is selective, i.e. can’t ‘see’ certain conditions. Example would be, for instance, that MRI can see damaged disc or cartilage, but won’t ‘notice’ muscle inflammation or, in many cases, nerve entrapment.
- If MRI didn’t notice anything, you’re told you have common ‘wear’n tear’ of the back, and given an anti-inflammatory.
- When MRI finds disc pathology, or arthritic changes in the spine – you’re scheduled for an injection (usually corticosteroid, or a ‘cocktail’ of pain-killer, anti-inflammatory, and a muscle relaxant)
- Injections only work in 50% of the cases, and when they do work, they only relieve pain for up to five months, and then the pain is back. You can’t get more than 2 – 3 injections to the same site. Then it is neuro-surgeon office…
- Success rate of spinal surgeries is 60%, half of those 60% will have return for a second surgery in 1.5 – 2.5 years, quarter in under 5 years, and 8 out of 10 of those who left will come back for another surgery in under 10 years. The statistics clearly show, that, in 10 years run, the cure rate of patients who’s undergone the surgery and those who didn’t, – is the same.
- Physiotherapy is indicated for back pain sufferers whether they’ve undergone the surgery (post-surgical rehabilitation), or not (main treatment modality). Considering the statistics on spinal surgeries, and the 10 year outcomes – MD’s and their patients should put more focus on physiotherapy.
Conclusion: drugs are being over-prescribed, injections are being over-prescribed, surgeries are over-prescribed. Physiotherapy is being severely under-utilized.
Lower back pain and Sciatica treatment exercise programme
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