Did you know that back pain is a completely normal part of almost everyone’s life? 90% of people will experience back pain at some point during their lifetime.
Did you know:
- Disc bulges are associated with a 2.5 times LOWER risk for lumbar spine pain – the bigger the disc bulge the better the expected outcomes.
That’s right, despite the negative press given to disc bulges, having one on an MRI scan actually makes you less likely to have pain, and more likely to improve if you do have pain.
Little known facts:
- The strongest predictor for an episode of lower back pain is depression, not MRI findings (2.3 times higher risk).
- Annular tears, disc degeneration and facet joint arthritis do not predict an episode of lower back pain.
- Education regarding lifting techniques with knees or a straight spine does not decrease the incidence of lower back pain (source)
- Education regarding sitting posture does not decrease the incidence of lower back pain
What does your MRI mean?
Did you know that “degeneration”, “disc bulges” and “stenosis” are all normal parts of ageing? Having these findings on an MRI scan does not mean that the findings are the reason for your pain. Only when your pattern of symptoms correlate with the MRI results do we start to take notice.
From a number of large studies we now know the prevalence of certain findings on a scan in people that have never had an episode of back pain. So if you have one of these findings, we can’t say for sure that your scan didn’t look like that before you had any pain.
Some interesting facts on MRI’s:
- At 20 years of age 45% of people will have “degeneration”.
- At 40 years old 68% of people will have “degeneration”.
- At 50 years of age 60% of people will have a “disc bulge”.
- At 60 years of age 23% of people will have a “spondylolisthesis”.
To take it a step further, here is a very famous study that showed the prevalence of MRI findings in people that did NOT have any back pain. So if the people without pain have disc bulges and the rest, then maybe the image isn’t the whole picture!
So what does all this mean?
Everyone’s experience with back pain is different. Some people hurt to lift with a bent back, some hurt to lift with a straight back. Some people hurt to sit up straight, some hurt to slouch.
Often the advice found on Google is a one size fits all approach that current evidence does not support.
Here is what we know does work:
- Motion is lotion – If you must rest, try and limit it to two days. After that, spend as little time as possible rested up, and as much time as possible moving, walking and bending. The key is to move as much as possible without aggravating your back pain.
- Extended time off work doesn’t help – At times it can be appropriate to have some time off, but in general, speaking to your employer to find suitable duties that can get you back into your routine has been shown to help you improve more quickly.
- Focus on what you can control – we know that a lack of sleep and high stress levels can delay your recovery. Make it your priority to get at least 8 hours sleep, and take some time out to do a hobby that you enjoy. Another great option is meditation (try Headspace if this is new to you).
- Speak to your doctor about appropriate pain medication – If there is not a traumatic incident that clearly caused your pain then chances are that your pain does not have an inflammatory component. Research has shown us that a standard pain killer is just as effective as an anti-inflammatory but without some of the side effects.
If you suffer from back pain or have any questions, call us at Gymea on 9526 6686, or Cronulla at 9544 4884 to get your problem fixed today.
Further readings:
How to Interpret Your Lumbar MRI Results – Erson Religioso
Challenging back pain myths pamphlet – Move 4 Health 2011
Understanding Persistent Pain – Department of Health & Human Services
Explain Pain (book) – Butler & Moseley
