Beat lower back pain: an expert opinion

Lower back pain is common. Over 80% of us will suffer from it. Unfortunately, there is a long-held view that lower back pain is usually caused by something mechanical, and can only be resolved with surgery. In most cases this is not true. There are many things that you can do on your own to alleviate the pain, without having to go under the knife. Our body is a remarkable instrument that is capable of recovering on its own, given sufficient time.

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Physiotherapy and rehabilitation can help you manage and recover from lower back pain, through a mixture of mobility and strengthening exercises.

If you have been experiencing intense lower back pain regularly, manual therapy and soft tissue release can help to reduce pain and facilitate movement. It will not be an easy journey. There will be sweat (lots of it), there may be tears (I can’t promise they won't be mine!), and there will likely be setbacks. These are normal, recovery is usually not linear and pain is not predictable. But at the end of that journey, you can be satisfied that you have earned your recovery. Not only that, you will become fitter, stronger,  and better equipped with practical and effective knowledge to avert pain in future.

An MRI scan is not always necessary

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An MRI scan is useful if you are planning a surgery, as it gives the doctor a good overview of your anatomy. It is also useful if you are displaying certain neurological symptoms, such as progressive leg weakness or a loss of bowel control. Your doctor and physiotherapist will screen for these conditions, which may indicate certain pathologies. In the absence of these, your MRI is just a very expensive “selfie”. It gives little to no value in helping the doctor come up with a treatment plan, or predict how you will respond to conservative treatment.

A good physiotherapist will base your treatment on your symptoms, thoughts, feelings, response to movement, and tests results. There are also numerous studies comparing the MRI results of people who have back pain, with those who doesn't have pain. In both groups, there is a remarkable similarity in the number of people with disc bulges and other degeneration symptoms. If these conditions are present in people who are not experiencing back pain, maybe they are not the main issues that are causing the pain.

Tips for Beating the Pain

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  • Stay active. People who remain active recover more quickly. It can be as simple as including a 20-minute walk each morning and evening.
  • Change postures regularly. Your back becomes sensitised by prolonged stationary posture & awkward movements - your best posture is your next posture.
  • Do regular spine-strengthening exercises. Don’t be afraid of any particular movements, even if they don't feel comfortable right now.
  • Practice, practice, practice. The exercises may leave you feeling sore at first, but you will get better with regular practice.
  • Be patient. Sometimes the pain can get worse for no reason at all. Be proactive and optimistic about treating it, but don’t blame yourself for making it worse.
  • Stay optimistic. The more you worry about your pain, the worse it might become - your brain acts like an amplifier.
  • Make sure you are getting a good night's sleep. This might mean making adjustments to the pillows you use, or your sleep posture.
  • Get strong. Strong supporting muscles can help to alleviate back pain, and also provide a whole host of other benefits.
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About the author

Kyle Wild completed his physiotherapy training in Leeds, UK and worked briefly in the NHS before combining roles between private practice and sport. He has extensive experience in contact sports, from initial injury management to post-injury rehabilitation . His passions lie in preparing people to perform within their chosen sports, with an emphasis on performance throughout the rehab process. You have to prepare your body for the stress and strains of what you enjoy doing, especially if you don't want to end up in the clinic because of it!