Have you ever felt like you’re alone with your back pain? That your family and friends just don’t get it.

…and your doctor doesn’t get it either.

Despite the fact that billions of dollars are spent every year in the US and other countries on treating back pain, and billions are lost in productivity because of it, back pain still seems to be somewhat of a mystery.

There’s just no definitive solution to your back pain. Sure, there are plenty of choices in the form of drugs, surgery, pillows, beds, exercises, etc, etc. But there isn’t one simple thing that you can do that’s guaranteed to cure your back pain.

You’d think that we could figure out some kind of solution to back pain, since it’s been studied for so many years in most industrialized countries of the world. So is there anything we can learn from the more than 1200 back pain studies and trials that have been published?

One thing that’s been established as a result of all this research, is that recommended guidelines for treatment of have been implemented in many industrialized countries…but are doctors actually adhering to the recommendations based on the published evidence?

Keep in mind that low back pain is initially treated by general practice physicians, both in the US and many other countries. And often, after a visit to your doctor about your back pain, you feel like you’re on your own.

So, perhaps we could learn something from a recent Australian study published in the Archives of Internal Medicine that looks at whether low back pain is being treated by GP physicians in accordance with international best practice guidelines.

You might not be too surprised to learn that Aussie general practice docs are NOT treating “new” LBP patients as recommended. One of the recommendations is that imaging (X-rays, CT scans etc.) is not initially advised, and yet in 25% of the cases, imaging was ordered by the doctor. It’s been established in both the US and Australia that imaging is not necessary for first onset low back pain, unless there’s a “red flag” in the initial examination.

There’s also some inconsistency with the guidelines about drug prescriptions — even though analgesics such as acetaminophen (Tylenol) are advised, many docs prescribed more dangerous medications like anti-inflammatories (such as Advil or Motrin), or opioids.

This is all quite interesting, but the portion of the guidelines that’s being ignored THE MOST by doctors, is the recommendation that doctors should be giving their patients advice and education about exercise and lifestyle options. The study found that only about 20% of the patients were provided with any sort of advice or education by their doctor. No wonder you feel like you’re on your own after you visit your doctor for your low back pain.

I’ve got a few problems with this idea of your doctor giving you advice and education about your LBP (never mind the fact that it’s not being done anyway).

Here’s why this scenario doesn’t work:

1. Your doctor doesn’t have the time – 15-20 minutes isn’t long enough for you to get  any education about how to care for your back.
2. Your doctor doesn’t have the training to educate you about posture, body mechanics, exercise and to give you the information that will help you understand the relationship between your body and your spine. Several recent studies of medical schools in the US and Europe have pointed to the fact that doctors are inadequately trained to deal with musculoskeletal conditions such as low back pain…and they have NO training in developing an exercise prescription, or analyzing movement, posture or body mechanics.
3. Expectations of our doctors are that we’ll get a diagnosis (= an “answer”), a prescription for the medication that will “cure” us, and perhaps a referral (for more tests, to a specialist etc.). This is an unrealistic expectation — both from the doctor’s perspective and from the patient’s…no one can find and treat the root cause and then “cure” your back pain in a 15 minute visit.

What you really need is a way to get advice and education from an expert in low back pain exercises, body mechanics and lifestyle modification so that you can understand your own body and cure your back pain…

So where can you go?

Where can you get the education and training you need to cure your back pain, without relying on unsafe medications to mask the pain, or spending thousands of dollars on unnecessary tests that won’t get you any closer to pain relief?

Well…in the current environment, where general practice doctors are stressed for time, and inadequately trained to deal with low back pain conditions, it seems as though you’re on your own. You may get a referral to a physical therapist, but in the US, PTs are just as time-limited as your doctor, getting only a few minutes each visit to work with you one on one.

You might try a chiropractor, acupuncturist, massage therapist or other practitioner, but many of these practitioners have no training in movement analysis, exercise prescriptions or body mechanics.

But there’s good news! You’re not alone…there are options:

1. Find a Physical Therapist who is trained in both manual therapy (working with your body to improve your overall alignment) AND movement. Pilates, Feldenkrais and Franklin Method trained PTs are ideal.
2. Find a Pilates teacher who has comprehensive Pilates training
3. Find a Feldenkrais practitioner
4. Find a Franklin Method Teacher
5. OR…Sign up today for the MASTER Your Back Pain System - the most comprehensive low back pain program on the web. The 30 day MASTER system combines the latest in movement science research, nutritional advice, the “how to’s” of sitting, standing and sleeping without pain, as well as a step-by-step weekly program to keep you on track.

So even though your doctor may not be following the recommended research-based guidelines for treating your back pain, there’s no reason for you be alone. There’s support, advice and education available…you just have to know where to look.

You deserve to have a healthy back, so if you need more resources, or have questions about successfully relieving your back pain, please leave me a comment below.

To healing your back pain.

Filed under: Back Pain studies, back pain, healing back pain by lindyroyer