06 Sep Low back pain – Has the system failed you?
Low Back Pain – has the system failed you?
Low back pain. Most of us will suffer back pain at some point in our lives, especially if we lift heavy weights, but not limited to lifting. Many of my clients aren’t even lifters but people who lift as a hobby. Some play basketball, run, are average joes, or are in the military. Some are stay-at-home moms who tweak their back doing chores around the house. Others suffer from car accidents and falls. The common theme for all of these clients is the medical system failed them. This article will discuss the primary ways I see the system fail back injured people.
Post-low Back Surgery PT – non-existent
Over the last 2-3 years, I have seen an increasing wave of clients reach out to me and other practitioners who have gotten low back surgery and are told they were good to return to everyday life with ZERO PT.
If this is you, you are almost doomed to fail, in my experience. One must rebuild before one returns to everyday life, and this is especially true for athletes. Steps must be taken to rehab and adapt the spine to load slowly. Failure to progress slowly can mean a lifetime of back pain and worse surgeries.
Cookie cutter Physical Therapy
Low back pain treated with cookie-cutter physical therapy will work for some people, depending on their pain generators, injury severity, therapist, etc. But, for many, at best, it will not help; for some, it will make them worse; even reinjure some. The bad news is therapy, at least in North America, is not very likely to help promote the healing necessary due to the necessity of back pain & injury needing specific treatments. In addition, many cookie cutter plans involve mobilization of the spine with stretching and particular postures, which will further exacerbate the damage, with silly stretches, and exercises that will feel temporarily good. Still, the pain returns shortly, with the area becoming more sensitized, therefore, more pained. It becomes a cycle of pain.
Their clinician gives no homework for back pain.
Some patients will start to feel better during PT, but once they finish the arbitrary number of PT sessions, their insurance will cover and forgo their therapy. As a result, clients have a false sense of healing. It can take years for a back to heal truly. They feel they have arrived and are ready to move and do as they wish. I tell all of my clients that if their PT or their Chiropractor or practitioner doesn’t assign them therapy to do on their own when dealing with a back injury, they are going to the wrong clinician. Avoid PT and Chiropractic packages that sell you on only going to see the clinician. I advise people to veer away from these practices. When you see your provider, you must do daily exercises and not just manual therapy (or other) with them. You only see them for a few minutes; what about the other 23hr + just on this day?
One of the worst things clients report to me is that their Dr., PT, etc., tell them they will never be out of pain. They are told they are screwed and have a lifetime of pain to enjoy. Or, worse, they are chastised and told they deserve their misery. I got this vibe from more than a few DR. Athletes hear they have to hang it up and will never be able to compete or enjoy their hobby again. While this may be true for some, I’ve seen many clients beat their pain and regain their life. Many can return to sport, though not all. I’ve witnessed too many cases heal up and get back on the lifting platform, on the field, behind the jet, racecar, or operational ready to go along with this narrative.
I could go on further, but you get the point. Unfortunately, many people don’t know that specialists exist. We can spend the proper time with you and give you the best possible shot at beating your pain. I experienced the flaws in the system. Thankfully I found someone like Dr. McGill, who showed me there are no quick fixes or cookie-cutters that can fix my pain. It comes down to a proper assessment, removing the causes of pain, and good progress in restoring pain-free capacity and building resilience, as discussed in Back Mechanic and Gift of Injury.