In this video, Leon discusses the 5 key takeaways from the Economist briefing on chronic back pain. Many of these points are aligned with the evidence we post regularly on this website.
Takeaway #1 – X-rays and other imaging procedures are not good predictors of pain.
- About 50% of the population undergoing MRI scans find some degree of spinal abnormality on imaging.
- These abnormalities may include bulging discs, herniated discs, spinal wear and tear, etc.
- These findings don’t always correlate with the pain a patient is experiencing – some patients have significant spinal issues but experience no symptoms.
- Results of imaging don’t always help determine the underlying cause of back pain.
- Sometimes imaging will find a spinal issue but that doesn’t always mean that issue is the source of pain.
- Further diagnostic workup is often needed to determine the cause of back pain.
- Disc degeneration is seen on imaging in about ½ of young to middle-aged adults with back pain, and in about 1/3 of patients with no back pain at all.
- Disc protrusion is seen on imaging in about 40% of patients with back pain, but also in approximately 20% of those who are pain-free.
- There is a broad consensus from the University of Southern Denmark that about 80% of such scans are useless.
Takeaway #2 – Prescription medications (like opioids) don’t necessarily help with back pain.
- Many doctors continue to prescribe medications for pain control, including opioids.
- Research is finding that these medications don’t necessarily help control back pain, but have other side effects, including:
- Making you feel loopy.
- Decreasing quality of life.
- These medications may also lead to addiction.
Takeaway #3 – Back surgery doesn’t actually help many back pain patients.
- Many patients have surgery but continue to experience significant pain several years later.
- For example – spinal fusion surgery is often used for degeneration of spinal discs. In 2015 approximately 85,000 of these procedures were performed. However, 2 years after treatment 87% of patients still had severe back pain requiring medication, and 15% had additional surgery
- Surgery should be a last resort after exhausting all conservative treatment options.
- Surgeons do not always follow the evidence.
- Be informed before undergoing back surgery – get a second, and maybe even a third, opinion.
Takeaway #4 – New research is coming out surrounding pain science.
- Research is showing that chronic pain can be coming from your brain as the brain interrupts the pain you’re feeling.
- A lot of people don’t want to hear this, or are uninformed about the connection between mental health and chronic pain.
- Stress at work, or in personal relationships, etc. may be contributing to your chronic pain.
- There’s a lot more to chronic pain than just the physical cause or what you may see on an X-ray.
Takeaway #5 – Exercise and stress reduction is proving to be effective for back pain.
- Daily exercise, including stretching, can help to control chronic back pain.
- Reducing stress with activities like meditation, yoga, Thai chi, and acupuncture can help to control chronic back pain.
- It’s important to not focus all of your attention on your pain.
In closing, stay active, avoid medications and surgery whenever possible, and try to treat yourself holistically.
Corrective Exercise Specialist (NASM-CES), Certified Personal Trainer (NASM-CPT), Professional Dancer
As a long time back sufferer Leon found unique methods to alleviate his pain using natural methods including self massage, exercise/stretching and postural habits. He founded Backintelligence.com to empower others to fix their postures and ease their back pain from home.