What You Don't Know About Back Pain & Exercise

NPR recently ran an article describing how "More than 1 in 4 adult Americans say they've recently suffered a bout of low-back pain. It's one of the most common reasons people go to the doctor. And more and more people are being treated for it." Image by @nunofit via instagram

"America spends more than $80 billion a year on back pain treatments. But many specialists say less treatment is usually more effective.

In fact, there's evidence that many standard treatments for back pain — surgery, spinal injections and painkillers — are often ineffective and can even worsen and prolong the problem.

Dr. Jerome Groopman agrees with that premise. He suffered back pain for almost 20 years. He was a young marathon runner 32 years ago when back pain struck out of the blue.

"I couldn't run. It was difficult to sleep," he says. "I wasn't confined to bed, but I was hobbling around."

While most people are afraid to work out or further exacerbate their back pain or injuries, they end up becoming inflexible and immobile, often causing more pain and less progress. The article goes on to say:

"This is a different way of thinking about pain. Normally pain is an alarm bell that says, "Stop what you're doing right now or you may hurt yourself!" But for many people, that pain is a false signal. It's not about looming danger; it's actually caused by hypersensitive nerves.

Rainville says that about 25 percent of patients with acute back trouble get stuck in an endless loop of pain. He thinks this chronic back pain is often due to persistent hypersensitivity of the nervous system.

Genetics may help explain why back pain becomes chronic for that 25 percent. But whatever the underlying cause, Rainville and others have discovered that many of them can learn to ignore their pain.

That process requires around six weeks of regular visits to a back pain "boot camp," where specially trained therapists gradually increase the intensity of exercises designed not only to increase the strength and flexibility of the back, but also to teach patients that it's OK to move normally again."

Rainville says, "people with chronic back pain often sacrifice parts of their life — playing golf or softball, running, picking up bags of groceries or grandchildren. Patients get so afraid of pain, they do anything to avoid it."

"They keep putting things onto this altar, thinking that's going to change the situation," Rainville says.

But it usually doesn't work. Instead, they get more paranoid about any twinge of pain, and all the while they lose strength and flexibility.

Eventually that message sank in with the skeptical Dr. Groopman. "It took about two months for me to really buy in that this was the way to go," he says. "Just let it go. Don't pay attention to it. ... And after about nine months, I was basically without any back pain."

Article seen on NPR January 13th, by by  and Richard Knox