Unfortunately, mechanical low back pain (LBP) remains the second highest reason for physician visits among adults in the United States. This condition will affect a staggering 75% of Americans at some point during their lives and 15-20% of the population has low back pain at any given time. LBP is the most common cause of disability among individuals younger than 45, only dropping to third leading cause of disability for those over 45.
Mechanical low back pain has many causes and may arise from a combination of sources. LBP may manifest in an acute condition, where most cases resolve within 2-4 weeks, or, less frequently, in a chronic state. Most cases of LBP arise from normal use and not from injury. Less commonly, it may occur from acute traumatic events, like car accidents, or from cumulative trauma, more common in workplace injury. Regardless of cause, mechanical low back pain generally presents with clear symptoms including low back stiffness, pain with sitting or standing, and/or numbness or tingling in the lower extremities.
The physiological causes of LBP are extremely complex and are thought to involve several different components of the body (including elements of the skeletal, muscular, and nervous systems). Physical trauma to parts of the lumbar spine and subsequent disk disruption, herniation, and degeneration result in nociceptive signals, or pain response. LBP may also arise from neuropathic sources like sciatica. Most cases of LBP are thought to involve a combination of nociceptive and neuropathic causes. [i]
There are many options when determining a course of treatment for patients with LBP. They range from simple, therapeutic solutions to drastic invasive procedures. Two common physician responses to LBP are intensive spinal rehabilitation (physical therapy) and lumbar spine fusion.
In a research study presented in the Journal of Family Practice, J. Fairbanks et al. examined the efficacy of these two methods in treating LBP. The study involved 349 patients between the ages of 18 and 55 who presented with chronic back pain lasting for at least 12 months. The patients were randomly separated into two groups, one treated with surgical spinal fusion, the other with outpatient physical therapy and exercise five times per week.
The results of this study are almost as startling as the incidence of mechanical lower back pain in this country. The patients who received physical therapy instead of surgery recovered to within 4 percentage points of the surgical patients on the Oswestry Disability Index, scored from 0% (no disability) to 100% (completely disabled). Those who attended therapy had the SAME results in walking and endurance as the surgical group.
The researchers also discovered an 11% incidence of complications in patients who received surgery. There were ZERO complications in the physical therapy group. Furthermore, researchers found spinal rehabilitation far more cost effective than surgery with the cost per quality-adjusted life year of spinal fusion surgery estimated at $92,000. [ii]
Anyone suffering from lower back pain ought to explore the option of physical therapy. Through therapy at a facility with a top-notch, established Spinal Rehabilitation Program like the one provided by Reddy-Care Physical Therapy, patients are able to regain their mobility and quality of life without incurring high cost and tremendous risk. Before you risk possible paralysis or other dangerous complications and spend money on costly, invasive procedures that require months of recovery and rehabilitation, speak with a physical therapist about managing your lower back pain!
For a free evaluation and spinal rehabilitation consult, please call 516-829-0030.
[i] Hills, Everet C., MD, MS. Mechanical Lower Back Pain. http://emedicine.medscape.com/article/310353-overview . March 24, 2010