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Fixing Your Lower Back Pain: Module 3 – Treatments to Avoid

As a patient, it’s almost impossible to know what treatments are worthwhile and which ones are just going to cost money and get you no closer to your goal – a pain free, functional and enjoyable life!

In today’s Insta World we are constantly looking for the next quick fix remedy. But again and again reality hits home as low and behold those quick and dirty tricks don’t fix anything.

There are literally thousands of different approaches to overcoming LBP and we are encouraged to just go ahead and try one to see if it helps. But I think about the problem a little different. The fact is that if your treatment, exercise and advice isn’t addressing the underlying causes of your pain (discussed in the previous modules) then the only benefit you are getting is a temporary one.

Medications for lower back pain

Medications are really great at taking away the pain. But they must be used with absolute caution as they are dangerously addictive and do nothing to fix the underlying problems causing pain.

These are the main types of treatment that you need to avoid if you want long term benefit:

  • Pain medications: it is now very well established that long term use of pain medications for LBP is outright DANGEROUS. It leads to worse outcomes, addiction, stomach ulcers and a host of other damaging effects on one’s life. In some cases this even leads to death. Needless to say I don’t recommend taking medications for LBP for any longer than a week.
  • Manipulations/adjustments: Although many feel like getting their monthly/weekly or even daily crack helps with their pain. What is this doing for you long term other than palliating your pain? Not a lot. There are 2 main reasons for this. 1. Spinal manipulation provides quite a strong reflex change in muscle tension. It makes you feel great while the muscles are relaxed. But this can be a bad thing because tension and pain are there for reason – to protect you from further injury. 2. The way in which a spinal segment is chosen to be manipulated is completely random, and simply put – that’s not good enough. If there is a problem that you are trying to fix then it should be identifiable. Even if 2 different practitioners examine the same patient. This doesn’t happen with manipulation. Remember that if the treatment is aimed at the symptoms and not the cause they will come back and nothing has been done to prevent further degrading.
  • Therapeutic ultrasound and TENS: Emitting sound waves or low level electrical current into your injury WILL NOT FIX YOUR PROBLEM. I think we all inherently know that it’s impossible but of course we want to believe so badly that we will try just about anything. And why wouldn’t you trust the caring practitioner that is offering it.
  • cortisone-injections-runners-is-it-safe

    Getting an injection is very tempting! With the promise of getting rid of the pain without any fuss. But you have a long life to live, if you want it to be mobile and functional you need to think of more than just the short term benefits!

    Cortisone Injections: Can cortisone reduce pain and give people a window of opportunity to move more freely and even give them a chance to forget about their pain? Most definitely. Is it a good idea? Majority of the time it’s not. Studies have shown that the patients who undergo these injections do far worse down the track. Do you think that’s because chemically taking away the pain leaves you free to go and destroy your tissues?

  • Strapping tape/Kinesiotape: Here is a news flash – wrapping your injury in tape won’t help it. The producers of these tapes talk about all sorts of benefits but none of them hold true. Focus on treatment that restores function and respects pathology. Not a tape that your favourite sports star gets paid to wear.
  • Acupuncture: Again, this is a reflex based system. Reflexes make you feel good short term, but don’t address underlying pathology like intervertebral disc injuries or adhesion. Do it for fun if you like but don’t expect it to help your low back.
  • Dry needling: This treatment has become quite popular in recent years. They saw the acupuncture guys with their cool needles and thought “let’s stick them in deeper”. The mechanism they claim it works is by releasing trigger points. The problem here is that you have to discover why you have trigger points in the first place. Again this is treatment focused on the symptoms and not the cause.
  • Massage: It might feel nice but is doesn’t fix anything. Do this as a relaxing therapy or post workout recovery tool. Not to try and fix complex musculoskeletal problems.
  • Exercises: These are a critical part of rehab when delivered at the right time to the person with the right problem. It is ALWAYS secondary to fixing poor mobility. I’ve lost count of the amount of times I’ve have patients come in and tell me that their “glutes arent firing properly” or that they have a weak core. That’s all good to know but if you can’t pass a mobility screening there is good reason that your muscles are weak

Remember! This is not an attack on these treatments but at some stage we must respect reality. If the focus of therapy isn’t directly aimed at changing the following

  1. Increasing mobility/flexibility/function
  2. Decreasing the amount of load that is on your injury
  3. Strengthening any specific weaknesses in the muscles

Then you can’t expect anything more than temporary relief from pain. The best way to frame it in your mind is “how would I like to be moving in 20 years?”

 

Next I tackle the obvious next question: What treatment should be the best for long term outcomes.

Thanks for reading and as always if you have any questions feel free to contact me at

dr.m.vibert@softtissesolutions.com.auDr Michael Vibert Chiropractor Dunsborough

–       Dr Michael Vibert

–       Integrative Diagnosis Clinician

–       Clinic Director and Chiropractor at Soft Tissue Solutions

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