Back pain is one of the biggest reasons
we seek medical care,
and low back pain is listed as a leading
cause of disability worldwide.
But there's a lot
of misinformation out there,
and along with it,
a lot of bad treatments.
(Music)
[Body Stuff with Dr. Jen Gunter]
So today, I want to bring up five things
you should know about back pain.
One:
Back pain isn't just limited to the spine.
Our back is made of bones called vertebrae
that run from your neck to your tailbone.
These vertebrae form the spinal column,
which houses the spinal cord.
Each vertebrae is also connected
to the others by ligaments.
Between each vertebrae are discs
which provide cushion and help absorb
and distribute pressure.
Within this structure of connections
are also joints, muscles,
tendons and nerves.
But our back isn't held up
by just the spine.
In fact, a lot of that work
is done by our core,
which includes our abdominal muscles,
low back muscles,
hips and glutes and pelvic floor.
The muscles in our core
take pressure off the rest of the spine.
Every day, we put
all kinds of pressure on our backs
when we walk, stand,
carry our groceries, lift boxes,
and even when we sit.
So it’s not only spinal pressure
but torn muscles or slipped discs
that could be contributing to back pain.
But pain itself is even more complex.
Often, it's how pain signals
are processed in the nerves,
or in the brain
that perpetuates the pain.
Other factors, like stress and anxiety,
can amplify pain.
This complexity is why treating back pain
can be so frustrating,
and why it's enticing to seek out
all sorts of medically suspect care.
Which leads me to two:
Chiropractic treatment
is not backed by science.
Going to chiropractors
for spinal manipulation is very popular,
especially in the United States.
But a study that looked
at 45 systematic reviews
found no evidence
supporting chiropractic treatment
as effective for any medical condition.
I'm not denying that people
who visit chiropractors
sometimes feel better after a session,
but studies suggest that the comfort
and relief from being touched
is most likely a placebo effect.
This is also a reminder
that chiropractic treatment
can sometimes be dangerous.
There are people who have suffered
vascular strokes after neck adjustments.
Three:
Imaging techniques like MRI or X-ray
don't always help
with diagnosing back pain.
For instance, you can be in a lot of pain
and get an MRI showing a pristine spine
with nothing out of the ordinary.
Or you could have no pain whatsoever,
and an MRI could turn up abnormalities,
like a bulging disc.
What’s more, sometimes,
when you do have pain,
and abnormality on MRI
may have nothing to do with it.
Additionally, an MRI doesn't always
capture what's happening with your muscles
or tell us how pain
is being processed in the brain.
There are instances when imaging
helps to rule out a serious problem,
especially after trauma or an accident,
or if there are red flags,
meaning warning signs for cancer
or troubling neurological symptoms.
But for the majority of people
with back pain,
imaging has actually been associated
with worse patient outcomes
and unnecessary surgeries.
Speaking of surgeries, four:
Back surgeries can sometimes
do more harm than good.
Researchers analyzed studies
on two types of spine surgery,
lumbar spine fusion
and lumbar spine decompression.
They found that neither of these surgeries
was more effective
than nonsurgical treatment,
which I'll get into in a bit.
Finally, five:
Physical therapy is a really good
option for back pain.
A well-designed physical therapy program
can often be very effective
at treating acute and chronic back pain.
But it does take work.
Good physical therapy
involves not just assessments,
but also a structured
home exercise program,
which you need to do regularly.
There are also multidisciplinary clinics
that can offer multimodal therapy,
like medications, physical therapy,
and, sometimes, injections.
What I'm saying is there isn't always
an easy fix for back pain.
The solutions take time
and sometimes need
a multipronged approach.
For now, you can show your back
some love by staying active
and doing exercises
that strengthen your muscles,
including your core.