Low back pain is incredibly common worldwide.

“Low back pain is the most burdensome global health condition in terms of disability, and high prevalence.”

The Journal of Orthopedic and Sports Physical Therapy

The prevalence and severity of back pain raises many questions for healthcare practitioners and patients alike. Perhaps the most pressing question to all parties is, “Why is this happening?” For patients and clients, knowing why back pain is occurring is the highest priority. It is very common to jump to conclusions when it comes to the unknown. As with many conditions, there is a wide range of possible causes of back pain, some being more serious than others. Therefore, it is important to be evaluated by a healthcare provider when you experiencing symptoms to rule out serious pathology. Luckily, most cases are not serious and physical therapists are well equipped to evaluate patients with the condition.

Why See A Physical Therapist For Low Back Pain?

Physical therapists receive extensive training in orthopedic evaluation in addition to education on non-orthopedic causes of pain that would warrant referral to a physician for further testing. In fact, every state in the United States has some form of what is called “Direct Access” which allows patients to be evaluated by a physical therapist without a referral from a physician. Part of the rationale for allowing physical therapists this autonomy in practice is to reduce the unnecessary time and monetary costs spent going to see a physician who commonly will refer a patient to physical therapy anyway. Physical therapists can identify signs and symptoms that red flags indicating the need for imaging such as x-ray or MRI.

With that being said, it is important to discuss and consider the possible reasons for musculoskeletal back pain. There are many structures in the spine that can be the source of pain. Some of these structures include ligaments, muscles, vertebrae, intervertebral discs, and nerves. However, there are two concepts that are key to understand, perhaps even more important than what anatomical structure is involved.

Key Concepts For Understanding Low Back Pain

First is the idea that pain is not necessarily always correlated to the degree of tissue injury. In fact, modern pain science has shown that pain is best understood as an alarm system and acts as a protective mechanism that is highly dependent on many elements of the peripheral and central nervous system. Because it is so dependent on our nervous system, pain can actually be significantly influenced by expectations and emotions. Therefore, the fear associated with the uncertainty of back pain can actually magnify the pain experience. This is one possible reason why research has shown that simply getting evaluated by a trained medical professional has an effect to reduce pain.

Another important concept to understand is called regional interdependence. Regional interdependence is the idea that different areas of the body influence each other in a variety of different ways. This means that seemingly unrelated parts of the body can be related when it comes to pain. In other words, the area of your body that hurts may not be the problem, but the result of a problem somewhere else.

What Can I Do?

Back pain is very common but it can also be multifaceted and complex. Understanding it is the first step at improving your low back pain. It is important to get evaluated by a physical therapist if you are experiencing back pain. A physical therapist is a movement specialist who is trained to perform comprehensive evaluation and develop a plan to address symptoms or refer to another medical provider. Therefore, Physical therapists are equipped to help determine what steps to take in response to the profile of your symptoms. Pain is a complex phenomenon that should be addressed but it is also a normal part of life.

Finally, pain in one location is often the result of dysfunction at another location and it takes a trained professional to identify the relationship between the incredibly dynamic parts of the miracle that is the human body. For more information consult a local physical therapist at Robbins Rehabilitation East.

Writen By: Devin Cervani PT, DPT

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