Back pain is not a diagnosis. It is a symptom in an area of your body. Just knowing the location of pain and description of the symptoms only provides some of the information needed to know how to intervene. Often spinal pain will exhibit a directional preference, simply meaning some movements or positions will be helpful and others will be hurtful.
A concept we frequently educate our patients about is the fact that spinal symptoms are often positional vs exertional. For example, with certain conditions sitting or driving can be very uncomfortable. However, walking or running may feel good or even reduce symptoms. This may not make sense at first until we realize that body positions for each activity are different.
All back pain has a cause – understanding this is the key to beating the pain. A proper assessment reveals the motions and postures that cause pain as well as the movements and positions that relieve pain. The goal of this newsletter is to give you some insight into why Dr. Iodice asks you such specific questions about your symptoms; such as, is the pain worse in sitting or standing? Or what specific activities preceded back pain that seemed to come out of nowhere. Also, why he has you do very specific exercises. The more you know about your back pain, the better you can avoid flare-ups of pain, and you will know what to do if you start to feel an aggravation of symptoms.
A spine specialist will guide their patient through an evaluation of specific motions and postures to determine what triggers pain and in what ways a patient’s mechanics are compromised. We ask very specific questions that will help identify pain triggers. Once triggers are identified, the goal is to avoid them. But often not by stopping an activity, much to patients’ relief. Rather, the first strategy is to modify activities. The patient may need to adopt new ways to sit, tie shoes, sleep, brush teeth, work out, or lift children.
When you are suffering from back pain, the first objective is to stop the cause of the pain to allow the tissues to desensitize. Typically, this is simply a matter of moving differently. For example, if sitting and bending to tie your shoes makes your pain worse, you need to modify those activities to stop the pain. You can learn to bend at your hips while keeping your spine straight to put on your shoes. You may need a lumbar back roll while sitting or try a standing desk.
You do not build up a resistance to pain. Rather pain causes more tissue sensitization. Initially, it is important to avoid the activities that cause pain to let the tissues rest and desensitize from the pain triggers. The vast majority of back pain can be controlled and altered!
Another objective is to complete pain-free movement and exercise. The secret is to determine the right exercises! The wrong exercise can cause more pain. You want to move and be active while avoiding your pain triggers. Proper muscle function is essential to support a healthy back. The muscles around the spine should contract in a coordinated manner. It is equally important to have core strength and flexibility. A back specialist can determine an exercise program that both avoids your pain triggers and strengthens your muscles to provide both stability and mobility in your back.
Simply taking pain medication for back pain is rarely a long-term solution. Medications can be used as part of a broader approach to addressing the root cause of the pain and developing a targeted treatment plan.
Try this to test your posture and determine a pain trigger.
*Sit tall on a stool and grab the seat with your hands and pull up with mild to medium pressure. This will compress your spine. You may notice no pain.
*Now slouch and repeat the compression.
*If you experience your familiar pain, then you just identified that bending forward with your back is a pain trigger.
*Next, gently arch your spine backwards and repeat the compression.
*If this reproduces your pain then you know that bending your spine backwards is a pain trigger for you.
This is just one example of the assessment that should be used to identify the cause of back pain and pinpoint motions and postures that aggravate the pain. Avoiding these pain triggers will allow a desensitization of the pain pathway. A specific and individualized diagnosis will guide each person on what not to do and what to do to rid themselves of pain.
Advanced Healthcare and Sports Injury is here to help you conquer your back pain and improve your spinal function for the long term! Contact our office to experience a thorough spinal examination!
References:
McGill, Stuart. Master Your Back Pain – All back pain has a cause. Impact Magazine. September 2018
McGill, Stuart. What Causes Back Pain? An In-Depth Look At The Trainer’s Role With Clients Who Suffer From Back Pain. Strength Matters. Strength Matters. September 2018
McGill Stuart. Empowering Self Advocacy: Taking charge of your back pain. Backfitpro.com. 2015
