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Pain relief proven ineffective for low back pain

Updated: Apr 15


A physio assessing a patient's back pain and an image of their spine on top of it

Back pain and particularly lower back pain is very common and affects most people at some point in their life. It usually feels like an ache or stiffness/tension in your back. It can be caused by a number of things, such as a sudden movement or fall which is easily identified or can be something that builds more subtly and slowly. Back pain can also be the result of other medical conditions.

Lower back pain is extremely common with approximately 80% of Australians experiencing it during their life and around 10% developing a significant disability as a result. It affects people of all ages. With this being such a big problem, many people turn to pain relief to get through. However, a recent Australian study has found that popular anti-inflammatory / pain-relief drugs such as ibuprofen have little affect on lower back pain. After reviewing the findings of 35 clinical trials of 6,000 patients using these type of pain relieving drugs, a senior researchers at the George Institute for Global Health, found that "six patients had to be treated with anti-inflammatory drugs for one patient to achieve a clinically important benefit in the short-term. And the drugs come with side effects."

Some of the facts...

  • Estimates from the Australian Bureau of Statistics 2007–08 National Health Survey suggest that about 1.8 million Australians (9.2% of the population) have back problems.

  • It has been estimated that 70–90% of people suffer from lower back pain in some form at some point in their lives.

  • Back problems are a common reason for pain among younger and middle-aged adults, but they can start early in life – between ages 8 and 10.

  • Pain is the key symptom in most back problems. One study of people with long-term back problems suggested that 14% experience constant or persistent pain, and 86% experience pain one day per week.

  • According to the National Hospital Morbidity Database (NHMD), in 2010-11 there were 93,564 hospitalisations with a principal diagnosis of back problems. The common reasons for hospitalisations were:

  • low back pain (27.7% of hospitalisations for back problems)

  • narrowing of the spinal canal (spinal stenosis) (14.1%)

  • pain including tingling, numbness and weakness in the legs that starts from the lower back (sciatica) (13.8%).

Causes of lower back pain...

There are many different things which can contribute to back pain, including:

  • An imbalance between the large muscles of the back/abdomen/buttocks and the small stabilising muscles of the back and pelvis

  • Injury or accident (Muscle strains, spine dysfunction)

  • Posture or work station set up issues

What to do about back pain?

Pain-relief and anti-inflammatory drugs don't address the root cause of the problem. For long lasting results there is value and an increasing body of research to support keeping/increasing your activity which has direct benefits on reducing back pain. Activities such as walking, Clinical Pilates and low impact exercise (like hydrotherapy) can play an important role in reducing lower back pain and getting back on track to pain free movement. It is important to seek professional help when starting any exercise where you are currently experiencing pain in order to diagnose and treat the root cause of the problem, not just the symptoms.

A physiotherapist can help address lower back pain through;

  • Postural realignment of the spine

  • Hands-on techniques including soft tissue release, dry needling, joint manipulation and mobilisation

  • Biomechanical assessments to reduce contributing factors from posture and ergonomics

  • Clinical Pilates, to create a balance between the stabiliser muscles and the movement muscles

  • Hydrotherapy (aquatic physiotherapy) which can help those particularly when post surgery, accident or injury are the cause of lower back pain.

A myotherapist or remedial massage therapist can help through;

  • Soft tissue massage including deep/sports

  • Trigger point therapy to release tight muscles

  • Dry needling & cupping

  • Relaxation massage which can assist in stress relief, this often has a positive impact on back pain

A podiatrist can assist though;

  • Reducing biomechanical imbalances using raises for leg length difference

  • Shoe inserts (orthotics/arch supports) to improve posture and function of feet, legs and pelvis

  • Shock absorbers and medical thongs with built in arch supports may assist

Book an appointment with one of our highly experienced health practitioners who will assess the underlying cause of your pain and work with you to resolve it.

SOURCES:

http://www.abc.net.au/news/2017-02-03/anti-inflammatory-drugs-no-better-than-placebo-for-back-pain/8236470

https://www.healthdirect.gov.au/back-pain

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