Talking back pain with U of M
Back pain is the leading cause of disability worldwide and an estimated 80% of the population will experience back pain at some time in their lives, according to the American Chiropractic Association.
Roni Evans and Gert Bronfort with the University of Minnesota talk about the causes, symptoms and preventative measures people can take to reduce back pain.
Q: What causes back pain?
Dr. Bronfort: The cause of back pain can be due to injury to one or more vertebrae, discs, ligaments, muscles or nerves in the spine and triggered by an aggravating incident (e.g., shoveling the snow) or physical changes that happen over time (e.g., arthritis). Stress, inactivity or some body positions may also aggravate back pain and contribute to it becoming a more long-term problem.
In many cases, it is difficult for clinicians to find the exact cause of back problems. The reason can only be found in about 15% of cases. The good news is that few people with back pain turn out to have a serious problem and can manage well without medications, injections or surgery.
Q: What are the symptoms of back pain and when should someone see a doctor?
Dr. Evans: Some people will experience a dull ache in their back muscles. Others might have a shooting or stabbing pain, or what feels like a ‘catch’ in their back. Back pain can be experienced on one or both sides of the body and may even go down the legs. It can slowly creep up over time, or it can happen all of a sudden.
Most back pain will gradually get better and isn’t a sign of something serious (although it might not feel that way!). The best thing to do when you experience back pain is to keep moving. Many tests currently used for low back pain, like MRIs, are not needed for most cases.
There are times, however, when you should see a health care provider. This includes if your back pain doesn’t get better within a few weeks; if it was caused by a serious accident or fall; wakes you up at night or is associated with weakness, numbness or tingling in one or both legs; or occurs with other symptoms.
Q: What are some risk factors for back pain?
Dr. Evans: Low back pain is what is known as a ‘biopsychosocial’ condition, that is there are several interrelated factors that can put someone at risk for getting back pain that becomes long-standing or chronic. These include physical factors (e.g., poor spinal strength and mobility); psychological factors (e.g., being depressed or feeling unable to cope with low back pain on one’s own); and social factors (e.g., heavy physical work load or having fewer social support systems).
Q: What can people do to prevent back pain?
Dr. Evans: You can help prevent back pain by:
- Keeping the muscles that protect your spine strong and flexible through strengthening and mobility exercises (i.e., muscles in the back, abdomen and legs).
- Moving frequently. This means not sitting or standing in a single position for long periods of time. If you have a desk job, set a timer to stand and stretch every hour.
- Keeping computer monitors at eye level, if you sit at a desk at work, while having your feet flat on the floor. Sit up! Think of keeping your ears, over your shoulders, and your shoulders over your hip bones. This will help accentuate the natural curves of your spine.
- Squatting down when lifting heavy things by bending your knees, keeping the item close to your body and lifting with your legs and not your back.
- Trying different sleeping positions to find one that is most comfortable. Try using a pillow in different ways (e.g., sleeping on your back with a pillow under your knees).
Q: What are you doing to advance back pain research?
Dr. Bronfort: We are currently performing one of the largest randomized clinical trials ever conducted on acute back pain, the most common reason for opioid prescriptions in the U.S. Funded by the National Center for Complementary & Integrative Health, the goal of the Spinal Manipulation and Patient Self-Management for Preventing Acute to Chronic Back Pain (PACBACK) study is to prevent pain chronicity and empower patients to better care for themselves.
This study is examining the effectiveness of spinal manipulation therapy (SMT) and supported self-management (SSM) versus medical care for preventing acute low back pain from turning into a chronic pain condition. SMT is a non-drug approach used by chiropractors, physical therapists, and osteopaths to help patients manage symptoms and restore movement and functional ability. SSM is an educational program that provides patients the tools to help manage their pain themselves from a whole person perspective (e.g., physically, psychologically and socially).
Dr. Roni Evans is an associate professor and the director of the Integrative Health & Wellbeing Research Program at the Earl E. Bakken Center for Spirituality & Healing at the University of Minnesota. Her areas of expertise include self-management strategies, complementary and integrative therapies (mind-body), wellbeing and musculoskeletal pain.
Dr. Gert Bronfort is a professor in the Integrative Health & Wellbeing Research Program at the Earl E. Bakken Center for Spirituality & Healing. His areas of expertise include self-management strategies, complementary and integrative therapies, wellbeing, musculoskeletal pain and spinal biomechanics.