As a physical therapist, I get the unique experience of not only treating many people with back pain and sciatica, but also hearing their stories. Its amazing how many different ideas are floating around regarding back pain. At times it seems that many of these thoughts and ideas are based more around myth than fact and sometimes can delay healing because of misinformation. Allow me to discuss some of the most common things I hear from people regarding back pain, and how using sound research and information may allow you to have a better understanding of back pain.
Myth #1. "I have a pulled muscle in my back." This is a very common misconception regarding back pain, especially when it is about back pain that lasts more than a couple of weeks. The reason for this lies in the real nature of muscle strains. Most muscle strains are self-limiting, meaning they usually heal themselves completely within 1-2 weeks, if not a few days. Its also important to note that a simple muscle strain will NEVER refer pain into the hip or leg as is the case in sciatica. So, anyone experiencing back pain that is not showing improvement within a few days likely has an issue that lies deeper than the muscles of the back, and can usually be addressed through specific mechanical movements and loading prescribed by a PT certified in Mechanical Diagnosis and Therapy.
Myth #2. "There is nothing you can do for my back. It's too far gone." People have been told for years by doctors and other professionals including some physical therapists that "degenerative disc disease" (DDD) or arthritis of the spine will be a never-ending cascade of back pain. Allow me to share what a lead back pain researcher, Julie Fritz, had to say in a recent article regarding degenerative changes in the spine. "[degeneration] should be considered more like wrinkles and grey hair." Degenerative change in the spine is a normal process of aging and the it is not a disease despite what the name implies. One might be surprised to learn that not all people with DDD or arthritis (the majority of people over 50) even have symptoms! And even if they do, they actually tend to get better with time, not worse. Usually improving range of motion, strength, and flexibility can significantly reduce and even eliminate an individual's back pain, even in the presence of DDD or arthritis.
Myth #3. "I need an MRI before coming to see you so that you know what you're working on." I have to fight off the urge to feel insulted when people say this to me. It completely discredits the hour-long mechanical evaluation that I perform on patients. This is in stark contrast with those who base their decision making and treatment based on a 2-D X-ray or MRI report. Recent research has shown that having an MRI prior to commencing physical therapy only leads to a higher amount of more invasive procedures such as injections. It also demonstrated that the outcomes of patients first receiving an MRI were absolutely no better when compared to those referred to PT first, but they did spend an average of $4,793 more compared to the PT only group.
Myth #4. Sciatica arises from tight hip muscles. Its a very common thought, especially if you google search "sciatica". The thought is that tight hip muscles (particularly the piriformis muscle) are somehow squeezing or choking the sciatic nerve. There is virtually no supporting research for this, nor is there any clinical substance in this claim. Sciatica is simply defined as leg pain arising from the back. Even if you don't feel pain in your back, the structures in the back including the discs, facet joints, and nerves can all refer pain into the leg. So if you just spend time stretching your hip muscles, you never address the root cause of your problem and could in fact be making it worse. The good news is that if you are given the correct spinal movements to perform based on a thoroughmechanical evaluation from a clinician certified in Mechanical Diagnosis and Therapy, you can usually get fast relief from sciatica.
Myth #5. "My back pain is the result of one specific event or injury." This is only true for about 10-25% of people with low back pain. It is much more common to see people with back pain who can't remember a specific event or injury. Even if the person can recall a specific moment of onset of their pain, usually the issue is the result of the high frequency of sitting and bending forward that life and our occupations frequently require. As a result of these factors, a specific movement or lift can then send their back over the edge. Again, a certified MDT clinician will evaluate your problem and discuss all of the possible predisposing factors you may have to help you avoid injury or re-injury.
BONUS MYTH: Physical Therapy is only for people who are in really bad shape or severe pain and need "rehabilitation". The truth is, if the individual is seeking care from a physical therapist who specializes in spine care, the ideal candidate for physical therapy is a working person who wants to be able to work pain-free or for the active person wanting to be more active. Seeking care early on during your back pain episode can prevent your pain from becoming chronic and / or more severe. You don't have to have a referral to seek care and it is an excellent first option! Many mistakenly think that all PT is just generic stretching and strengthening, but visit www.LivingBetterPT.com to see a better option!
To Conclude: Another common misconception is that treatment for back pain is something that can only be administered to you. The truth is, with the right advice, you can be taught how to self-treat your back! This active patient involvement approach will give you the tools to not only rid yourself of back pain, but also educate you on how to stay better for life! Click here to see if the evidence-based principles found within the MDT system are appropriate for you. If you live in the greater Somerset, Monticello, Nancy, Eubank, Lake Cumberland, Pulaski Co, Rockcastle Co., Casey Co. Kentucky area and would like more information, please visit www.LivingBetterPT.com.