Stay active to keep chronic low back pain at bay

Low back pain has been one of the leading causes of disability globally for nearly three decades.

Last year, 245.9 million new cases of low-back pain emerged around the world.

It is often trivialised, made out to be only a part of life, certainly nothing to bang on about. But low back pain has been one of the leading causes of disability globally for nearly three decades. Last year alone, 245.9 million new cases of low back pain emerged around the world, according to the latest estimates from the Global Burden of Disease Study, published in The Lancet. Low back pain is becoming a bigger problem, driven by an ageing population and sedentary occupations and lifestyles, particularly in low-income and middle-income countries. Four out of five Australians will experience low back pain at some point in their lives. Acting on the complaint is imperative; most cases respond to simple physical and psychological therapies. At the other end of the spectrum, severe spinal injuries can require medical intervention and ongoing care. If you have back pain, you’re certainly not suffering alone — and hopefully, sooner rather than later, you won’t be suffering at all.

It may seem counterintuitive, but keeping active may be the best response to low back pain.

NPS MedicineWise medical adviser Jeannie Yoo, a GP, says some people wrongly believe they need a scan for every new episode of low back pain or should automatically take to your bed.

“Don’t stay in bed,” Yoo says. “Get back to your usual activities including work as soon as you can. It may hurt at first when you’re active, but this doesn’t mean you’re damaging your back. In fact, staying active reduces your overall amount of pain and time off work, and speeds up your recovery.

“For around 90 per cent of people with low back pain the cause can’t be found, which is called non-specific pain. Serious causes of low back pain, on the other hand, are rare.

“With non-specific low back pain, scans have limited usefulness. They won’t change the decisions made about your treatment and can even be harmful.

“In terms of other options, heat packs can help relieve pain. For more severe pain, medicines can have a role. But don’t expect them to stop your pain completely. If they’re needed, take them to help you stay as active as possible.”

Adolescents with frequent back pain are likelier to smoke, drink alcohol and report feelings of anxiety and depression, according to a University of Sydney study.

The study of more than 6000 Australian teenagers, published in the Journal of Public Health, found the proportion of adolescents who reported smoking, drinking or missing school rose incrementally with increasing frequency of back pain.

“During adolescence pain from bones, joints, muscles, and back pain in particular, rises steeply,” says academic Steve Kamper, an associate professor.

“Despite being the cause of substantial healthcare use and school absences, pain in this age group is commonly dismissed as trivial or fleeting. This study shows that adolescents with frequent pain are also at increased risk of other health problems, which is of concern as both pain and these risky behaviours have ongoing consequences that stretch well into adulthood.”

Kamper says that while back pain may not be the cause of risky behaviour or mental health concerns, it may play a role in characterising overall poor health and risk of chronic disease into adulthood. He wants further research into the links.

Retired US Army master sergeant Justin Minyard recently took part in a roadshow organised by the Australian Pain Management Association to demonstrate that even those with severe back injuries can manage their pain.

The 38-year-old from Florida has experienced chronic pain since being injured responding to the Pentagon crash during the September 11 attacks in 2001, then falling from a Black Hawk helicopter in Afghanistan.

Having become dependent on medication, Minyard felt trapped, and he says “living with inadequately treated chronic pain controls every aspect of your life”.

For Minyard, it took some personal persistence, and ultimately the implantation of a spinal cord stimulator, to give him back control.

“Being able to now effectively manage my chronic pain has given me a second chance to be the husband and father I should be.

“My advice to Australians living with chronic pain is to be your own advocate and educate yourself. I want to help others on their chronic pain journey because I’ve been through it, and come out the other side.”