Updated: Jun 17, 2020
As a general rule, I’m not a stats guy unless we’re talking baseball but stick with me. (Shameless plug: If you want to read something crazy, google Tony Gwynn or Greg Maddux crazy stats. They will blow you away.) However, some of the statistics on low back pain might be crazier in the scary and depressing sort of way.
Low back pain (LBP) is the number one cause of missed work days in the United States and the second leading cause of disability.1 Studies have reported that the prevalence of low back pain in the US is astronomical with upwards of 80% of Americans experiencing low back pain during the course of their lifetime and that 20% of Americans are being treated for low back pain during the course of one year.2 What is even worse is the toll it takes on the American economy. An in-depth analysis of the direct (healthcare costs) and indirect (absent work, disability wages, etc) costs of low back pain determined that the annual cost of low back pain is over $20,000 per patient.3 Those who suffer from LBP are typically in the most productive age range of their lives in terms of the economy and the nature of LBP tends to be chronic and long-lasting.
Have you ever wondered why back pain is so prevalent in the United States? With all of the advances in science, medicine, and technology, it seems like our healthcare system should be more successful in treating a condition like mechanical low back pain. What is the hold up?
Our biomedical model for healthcare typically creates this idea that pain is directly linked with tissue damage. The biomedical or medical (sometimes also known as the bio-mechanical) model of health, is a scientific measure of health and regards dysfunctions/disease as the human body having a breakdown due to a biological reason. This model fosters a societal expectation that if we have musculoskeletal pain, then we need to get those tissues fixed or realigned or manipulated. We become fixated on what is considered “normal” and convince ourselves that we must be in pain because we are out of normal posture/alignment/tissue integrity.
Biomechanists find the dysfunctions and they want to fix the physical impairments. The logical conclusion of these actions is that we will be pain-free and able to function properly again. Right? -- Well, not exactly. If this methodology was the primary means of LBP and subsequent treatment, then our spinal fusions, discectomies, and core strengthening regimens would see great results. But unfortunately that’s not the case.
“Medical culture does a particularly fine job of enculturating newcomers into its rituals and norms--almost all adopt the values, assume the behaviours, and embrace the ideals of medicine for better or for worse, without even knowing it.” - Nicole Piemonte in Afflicted.
So how do we get these patients better? How should PT’s and other healthcare providers treat low back pain? There is a community of health professionals that are now pushing a Biopsychosocial model of medical rehabilitation. Biopsychosocial rehab is a holistic, interdisciplinary model that looks at the relationship between biology, psychology, and socio-environmental factors and how they play a dynamic role in an individual’s health and wellness. The biopsychosocial model is not new (plug for George Engel’s 1977 paper), but it is not the basis of what is taught in medical schools and therefore is not the basis of the majority of most cookie-cutter physical therapy institutions.
The point of this article is to spark a greater understanding that sometimes the biomedical/biomechanical schema isn’t the end-all be-all. Sometimes there isn’t a physical impairment associated with your pain. Not to say that the pain you might be experiencing is not real. It is VERY real. It just might not be directly linked with structural or tissue damage. There is more and more research being released every day to actually suggest the contrary: that chronic low back pain is typically not linked to acute tissue damage. The correlation between the two is mediocre at best.
In summary, if you are experiencing low back pain, or any musculoskeletal pain for that matter, please take ownership of your own healthcare experience and find a practitioner that will look at the whole picture. Find someone who understands the biomechanical aspects of movement and function… but also can appreciate that it is not the whole story and who will dive into the bigger picture that is health and wellness. At Prime Performance Rehab, this is what we believe and this is what we stand for. The human body is capable of so much more than we give it credit for. Let us help you unlock your potential today.
For a free consultation or to set up an appointment, email us at firstname.lastname@example.org or stop by our clinic today!