If you are reading this article, I’m sorry. Back pain is awful. I know because I have had it put the brakes on my life for years. It’s gone now, but what a winding road it was. Before you go down this path and start trying remedies, it’s good to have a map so you know what you are getting into. It’s also good to cast a broad mental net so that you don’t get rat-holed into a particular way of thinking about back pain. You may very well need surgery or you may just need to rest or it may be something entirely different. You have to be open. It’s hard when you are in pain, but do it anyway. It will shorten your pain journey.
Get educated (I say this a lot)
Overall, you should know that back pain is indiscriminate and affects 8 out of 10 people in the US. So, it happens a lot to a lot of us. There are many studies on back pain indicating paths that are probably different from what you are thinking. Check out these critical studies listed in step 1 here.
Get an overview of doctor behavior as a whole and what the guidelines are for low back pain
Right now, doctors are doing more opiate prescriptions than physical therapy prescriptions even though for most people exercise of the spinal musculature is likely the most useful solution. Over at Harvard Heath Publications, this is called out directly. Interesting isn’t it? There are specific guidelines but patients know about drugs, MRI’s, injections and surgery types. They ask for these advanced protocols and pressure the doctors who want to help them.
Here are the current evidence-based medical guidelines
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call for treatment with non-steroidal anti-inflammatory drugs (NSAIDS, such as ibuprofen and naproxen) or acetaminophen (Tylenol and generic).
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call for referral to physical therapy when appropriate.
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advise against early referral for imaging (such as MRI and CT scans) except in rare cases where “red flags” suggest something other than routine back pain.
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advise against prescribing narcotics.
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advise against early referral to other physicians for injections or surgery.
Notice, surgery and injections are not on the list.
Read a personal story and journey to see how others resolved back pain
My back pain journey was a lot longer (with many more trials and a surgery) but also very similar to that of Jane Friedman. Her journey, detailed here, included a primary care doctor, waiting to heal, ergonomic changes, posture work, and fitness training. In the end, it was finding a real specialist using the Egoscue method and structural integration reset…also known as Rolfing.
Get an assessment by an expert
After you see your primary care doctor and rule out anything terrible, get connected with Egoscue and see if muscle imbalances are the cause due to irritating movement patterns. If you pull apart a cut every day, then healing can’t happen. It’s generally the same with the spinal musculature. As an example, if you are always hunched over with a backwards tilt of the pelvis for hours at a time, how can your back muscles get trained to be erect? That’s what the erector spinae muscles do. They erect the body. That hunch and tilt has to be revealed and corrected.
Get familiar with corrective movements
SpineUniverse is a great resource and has a lot of information on the site. It’s huge and can be overwhelming when you want to quickly get an answer that’s relevant to you. However, they do organize information very well and are able to cover many conditions. The key reference there is the list of exercises and stretches that are likely beneficial for back pain. Most often, people are charging for this information. They list it for free. Once your doctor has checked you out, integrate these movements into your daily routine.
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Connect with me and I’ll keep you up to date on the latest studies and interventions that are working for people. I’ve got an email newsletter I do weekly to help people form healthy back habits. Send me an email anytime, and I’ll see what resource might be best for you to check out.