How To Fix Lower Back Pain

Hey there, welcome to the Stay Healthy El Paso Podcast. I'm your host, Dr. David Middaugh, physical therapist over at El Paso Manual Physical Therapy. And I'm going to cover with you today how to get rid of lower back pain. Now this is a simple explanation from the perspective of a specialist physical therapist. I'm going to get into the nitty gritty details about how back pain develops, how the medical field at large looks at it, and then a proper level headed way to move into fixing it for the long term.

I split this up into seven pieces. So I’m going to cover each one by one.

Number one, understand that it’s a process and not a procedure to fix a lower back pain problem.

What I mean by that, just to unpack it a bit more, is many people even in the medical field believe that fixing a lower back pain problem is just a matter of having a procedure done or a technique or a medication. In other words, they have this belief that you do this one thing, and when you’re done with that one thing, then you come out with the back pain gone or resolved. And it’s just not the case.

The fact of the matter is, it is a process to properly fix a lower back pain problem for the long term. Now it can be a procedure or a technique or surgery or something like that, to get short term relief of back pain, it is possible to get pain gone today or maybe even for a few days or maybe even for a few weeks or months. But to properly fix it for the long term where you feel like you have control over the back problem, and you know what to do to make it stay healthy and not allow that problem to come back and turn into a worst problem as time goes on. That is a process.

I see it so many times where a patient comes in for their first appointment with us here in the clinic. And they’ve got a back problem. And they said, I’ve tried this, I’ve tried that, I’ve tried seeing this person and that person, this medical expert, and this medication and this exercise and this and this and that. And many times, I’m listening to them thinking, well, you’ve tried many aspects of the process, but haven’t really been guided on how to walk through all of those pieces in a structured strategic manner to fix the back pain problem.

And that’s part of the issue, it’s just not organized, and it’s not done well. And there’s a false expectation that this one thing that you do that one medication you take, or that injection, or that one visit to the doctor is going to fix it for good. But it’s just not the case. It is a process over time, and learning has to occur.

I’ve got small children now that are learning how to read. And it’s not just one class are learning the alphabet that gets kids to read, it’s practice and replicate and development. Once they learn how to read a three-letter word, and they’ve got to expand to a five-letter word, and then you have more complications to reading like plurals and conjunctions and irregular plurals. There are all kinds of different aspects to learning how to read. And it’s a process.

It’s a process that happens over time. But in one day, you might learn one aspect of it and then the next day, you want another aspect of it and as you keep building on that over time, then you develop a process that helps you meet the outcome, which for somebody with lower back pain, they want it gone forever and not ever have to step into a surgeon’s office to get something handle there, or to get injections or medications for the long term.

Number two, don’t be afraid of big words for medical people.

The same thing when we get patients in for their first visit for a back pain problem, oftentimes, they hear stuff like degeneration, osteoarthritis, osteopenia, facet arthroscopy, they throw all these big terms out there. And it’s quite scary for patients, especially if they’re not in the medical field or don’t have an understanding. It’s quite scary for patients to hear that.

And then inevitably, what patients will do is they may get an MRI report or, or some documentation from the doctor’s office where they just remember the word and they write it down, or they start googling it, and they find all kinds of terrible things that happen in extreme cases of those conditions that are described in those big words.

But the reality is that in nine out of ten back pain cases, where a doctor or a physician or some medical expert might tell you have facet arthropathy, or degenerative disc disease or so they throw out some of those big terms, and nine out of ten of those cases, they’re fixable. Without surgery, medications and injections, and they do stay better for the long term.

It’s really the minority of people that need to have some sort of procedure done or something invasive. Or where they have to face that they’re going to have some discomfort, or some level of their condition lasts for the rest of their lifetime. But that’s really just a small percentage of cases.

Number three, wait as long as you possibly can before getting an MRI.

There are other imaging procedures that are done x- rays, CT scans, and those are a little lower level than an MRI. And what you have to understand about getting an MRI is that it’s, it’s pretty detailed, but there’s also a high risk for what we call false positives. Meaning they found something that’s on the MRI, but if we were to open up the body and look inside, it’s not really there. It’s just the way the MRI image was produced. It looks like there’s something there that isn’t, so that’s a false positive.

The reason a MRI report might say, you have arthritis at this level. And in reality, you don’t, it was just a distorted image on the MRI. So if you go get an MRI, what it does is it opens you up to potentially having conversations with the doctor about getting procedures done in parts of the lower back, that may not even need anything done.

The reality of this, and we have it proven in research is, that it’s rarely the case that where there’s a problem on an MRI, that’s the source of pain. They’ve done research studies where they have found that they’ll do MRIs on everybody, on a bunch of people that have back pain and they’ll do MRIs on people that have no back pain. And they’ll find that across the board, whether they have back pain or not, there’s positive findings are they find stuff that’s wrong with their MRIs in their low backs.

Doctors can’t really categorize who has pain or who doesn’t, if they’re just purely looking at MRIs because somebody that has no back pain could have arthritis in their MRI or some disc problem on their MRI, but they’re okay, they don’t have any problems in real life and they’re able to do everything that they want to do.

So this is good news because it is possible for you to go get MRI if you’ve already had an MRI, have some positive findings on there have some disk issues some arthritis problem, but then it resolves, it gets better. But if you had an MRI after the fact it might still be there on the MRI because you’ve converted into one of those people that no longer has back pain but has a positive finding on an MRI.

Your best bet is to pursue natural treatments, pursue noninvasive treatments so that you can avoid having the MRI and then having to end up, because doctors are recommending you to go into some sort of invasive treatment or some medicinal treatment that has some side effects potentially for you.

Number four, exercise is king.

When it comes to lower back pain across the board, if you look at all the medical literature, all the scientific research studies, some form of exercise tends to produce positive results in people that have lower back pain.

Now that’s a big huge generalization. And the fact is we get patients to come into the clinic all the time that say, they’re listing out all the things, they try to try this, I’ve tried that. Some of those are, I’ve tried crunches, and I’ve tried squats. and I’ve tried this exercise I found on YouTube and this other one that was recommended to me for my friend, and my family member who resolved their back pain, but it didn’t work for me.

The fact of the matter with exercises, finding the right ones for your specific back problem is what needs to be done. There’s likely some muscle that needs to be strengthened, or some exercises you need to start out with, and then over time work into harder exercises, because it’s a process it’s not a procedure. In order to fully resolve a back problem and keep it gone for good.

And number five, if exercise is king, then habits are queen.

What I mean by that is, what you tend to do in the body position and the way that you move when you’re doing those things. If you have a desk job and you tend to sit for longer periods of time, or if you love watching shows on TV, then you probably also sit for long periods of time. Now where you sit, the way your chair is set up, the support on the chair, if you drive a lot, the car seat that you’re in its support as well, might affect the position of your back. And it could affect the health of your back.

The habits that you’re in, greatly affect your back problem. It’s also the movement, how you move through life, the way that you walk, the way that you get up. your exercise routine that you keep or don’t keep, the habits that you do are a big deal.

Here in the clinic, when we see patients with back pain, we’re often asking them about their daily routine about their lifestyle, so that we can get the information we need to better guide them on how to modify those things, the way they sit the way they move their exercise routine so that they can build good habits or tweak their mediocre habits so that they become good habits so that it benefits your back problem.

Number six, there will be ups and downs in getting your back pain problem taken care of.

Just understand that. And I tell this to patients all the time, whenever they start out here in the clinic, that you’re probably going to get better right away, you’re going to start feeling better here within the next couple of weeks, and then expect a flare up. Because inevitably, as people feel better, they get a little more confident they start wanting to do the things that they love to do before they had back pain. And they’re not quite ready for it unknowingly, and the back pain flares up again.

It’s that vicious cycle that oftentimes kills people’s motivation to drive forward into something because they assume that what they were doing didn’t work because the pain returned. But in reality, that’s just the way life is. It’s never a linear improvement where each day is better than the last day, it gets better and better and better and better and it just goes straight up in a straight line. It’s more up and down like a like the waves are a roller coaster. One day may be good, the next thing might be bad.

But as long as you’re following the process of how to fix your back pain problem for the long term, then overall as time goes on, you’ll trend in the right direction and you should be able to take care of your back problem for good.

Number seven expert help will expedite the process.

This is where I want to recommend to you that you get in touch with an expert physical therapist or some specialist that you feel is best suited to handle your problem. Now if you’re looking for a natural solution, I definitely recommend the specialist physical therapist. If you’re seriously considering that your back pain problem might need surgery then please go talk to the orthopedic surgeon or the best person for you.

But if you’re looking to naturally resolve your back problem, an expert physical therapist can guide you on the exercises that you need to do, discuss with you the habits that you have, other aspects of your back pain problem, the history, old injuries that you’ve had, and also do have hands on work to make sure that any joints that are not moving well any muscles, tendons, ligaments, other soft tissues that need to be broken up or freed up, get freed up as fast as possible, so that when you go to do exercises, they’re their most successful for you and you can progress through them as fast as possible.

And going back to number one, it’s a process, not a procedure, so that you can shorten that the length of that process. fixing a back pain problem on your own very well could take you a year or more. Here in the clinic, we whittle it down to a couple of months, sometimes even shorter, depending on the severity and how many other factors are involved that may be longer. So getting in touch with an expert and working with them will tremendously speed up your process in order to get you the outcomes of getting rid of this back pain problem for good.

Well, thanks for listening to our podcast here. I hope that this podcast was helpful for you, I hope that my voice is getting into your head just a little bit. Whether you're running right now, exercising, or driving, or just doing chores around the house, I hope that you might stop to take a few notes and think about what it is that you're doing, and how you're handling your back problem if you've got one.

And if you don't, and you just thought this was helpful for you please share this podcast with somebody that you think needs to hear this. And one more quick request. If you've been listening to this for a while, or even if this is the first episode that you hear, and you thought that it was pretty good, please take a couple of minutes and just give us a five-star rating on the podcast platform that you're listening to this on. Whether it's the iTunes, Stitcher, any other podcast platform that we have out there, we're on all the major ones.

Please give us a review about how this was helpful for you. It helps us a lot so that we can get this podcast into the hands of other people that need to hear it so we can get more visibility or listen ability on this podcast. And as always, if you have any questions, you can call us at 915-503-1314.

If you're interested in working with us, that's a number to call and just begin to tell us a bit about your back problems so that we can see if it's the right one for us to help you with. You can also go to our website at www.EPmanualpt.com and find the cost and availability tab and you can inquire about what it takes to see us and if it's right for you to see us. And if you're just looking for more helpful resources on that same website go to the blog tab and you'll find tons of helpful blogs on how to fix a lower back pain problem in addition to other body parts that we serve as well. Thanks so much for listening and have a wonderful day guys.

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