What's the Deal with Low-Back Pain?
I’m channeling my inner Jerry Seinfeld for this article. But seriously, what is the deal with low-back pain (LBP)? Low-back pain is the most common type of pain that people experience and almost everyone will experience LBP at some point in their lives (3-5,7). Some people are fortunate and the pain is not severe, subsides within a few days, and does not return. But for many people the pain is severe, prolonged, recurrent, and debilitating.
The financial burden of low-back pain
The pain can be so bad that life gets completely interrupted. Getting to the gym? - not a chance. Morning run? - good luck getting out of bed. Biking to work? - well, unfortunately there is no work because you are no longer a productive employee. Which might mean you’ve lost your ability to earn income. In fact, it is estimated that LBP creates a financial burden in excess of $100 Billion in the U.S., two-thirds of which is due to lost wages and decreased productivity (7). Don’t just breeze past this point. $100B! That is immense. There are over 100 countries in the world whose nominal GDP is less than that!
quality of life with low-back pain
And while the financial aspects of this problem are troubling, what LBP does to quality of life is downright cruel. People that were once avid runners, hikers, and cyclists can end up barely able to walk. And spending prolonged periods of time in certain positions such as sitting can be extremely painful, making car or air travel to visit family and friends out of the question for some. Understandably, people become desperate to stop the pain. Conservative options such as physical therapy and injections work for some and should always but considered, but inevitably hundreds of thousands of people end up getting a surgery every year that, according to some researchers, may not even work that well (1,2,6). Basically, LBP is cruel and expensive sonofabitch.
Treatment and prevention of low-back pain
The good news is that there are increasingly effective ways to prevent and treat LBP, and if you are currently dealing with this affliction, you are not alone. Researchers and clinicians are regularly uncovering new information on the etiology of LBP and new methods of prevention and treatment. Being educated on this topic is key so that you can take preventive measures and have an informed discussion with your clinician. We will sort through all the information out there and present it here in a language you can understand.
Be sure to check back soon to take a deeper dive into the causes of LBP, preventive techniques, as well as conservative & surgical treatment options.
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References
Bogduk N, Andersson G. Is spinal surgery effective for back pain?. F1000 medicine reports. 2009;1.
Chou R, Baisden J, Carragee EJ, Resnick DK, Shaffer WO, Loeser JD. Surgery for low back pain: a review of the evidence for an American Pain Society Clinical Practice Guideline. Spine. 2009 May 1;34(10):1094-109.
Crow WT, Willis DR. Estimating Cost of Care for Patients With Acute Low Back Pain: A Retrospective Review of Patient Records. J Am Osteopath Assoc. 2009;109:229-33.
Deyo RA, Mirza SK, Martin BI. Back pain prevalence and visit rates: estimates from US national surveys, 2002. Spine. 2006 Nov 1;31(23):2724-7.
Dunn KM, Croft PR. Epidemiology and natural history of low back pain. Europa medicophysica. 2004 Mar;40(1):9-13.
Fairbank J, Frost H, Wilson-MacDonald J, Yu LM, Barker K, Collins R. Randomised controlled trial to compare surgical stabilisation of the lumbar spine with an intensive rehabilitation programme for patients with chronic low back pain: the MRC spine stabilisation trial. Bmj. 2005 May 26;330(7502):1233.
Katz, JN. Lumbar disc disorders and low-back pain: socioeconomic factors and consequences. J Bone Joint Surg 2006;88-A Supplement:21-24.
In Part 6 of this series of articles, Cathy describes her daily core strength and flexibility routine to stay strong and mobile.