Managing Chronic Low Back Pain

IMAGE If you have never suffered from low back pain, consider yourself one of the fortunate few. Back pain is a common reason for Americans under the age of 45 to limit their activity. It is also a common reason for visits to the doctor and for surgery. There is some good news, though. Most people recover from an acute episode in a few days or weeks without much disruption to daily activities or medical treatment. For others however, low back pain becomes a chronic or recurrent condition, often resulting in considerable social and occupational disability.

Why So Common?

Many factors contribute to low back pain, such as inadequate fitness, heavy lifting, and poor posture. But our evolutionary history is to blame for our susceptibility to this pain. At some point in the distant past, some of our ancestors decided to stand on two feet, presumably so their hands would be free to fashion tools and use them efficiently. While their reasons were good, going vertical was not without its drawbacks.Walking around on all fours distributes the force of gravity evenly over the length of the spine. Standing up, however, concentrates this force in one location—the lumbosacral region, just north of the buttocks. Our vulnerability to low back pain is the price we pay for bipedal locomotion. Several factors can contribute to persistent back pain:
  • Having a work-related injury, particularly if the work environment requires or allows use of improper body mechanics, such as bending or twisting when lifting.
  • Having poor ergonomics for sedentary workers
  • Having a degenerative disease, such as arthritis, of the spine
  • Being overweight or obese

No Obvious Cause

Most cases of chronic back pain are idiopathic, meaning they have no clear explanation. Without a known cause, treatment is very difficult and often unsuccessful. This leads many people to alternative therapies. Below are among the most commonly used alternative therapies to treat chronic low back pain:There is some evidence that, at least in the short-term, each of these therapies may be effective at alleviating discomfort, improving function, and/or enhancing a sense of well-being. However, it is unclear if any one of these therapies is superior to the others or to physical therapy, the standard conventional treatment. Furthermore, it is unclear that any of these approaches provides more than short-term benefit.

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