Ever experienced a bout of back pain? Chances are you have. Up to 80% of people will experience a period of back pain in their life and it is the second most common cause of disability in US adults. For most of us, the pain will resolve and we will get on with our lives. However, up to 44% of people with back pain will suffer from recurrent episodes of pain that can arise repeatedly over the course of their life. Needless to say, this is a real source of stress, lost wages from time off of work, and reduced quality of life.
To make matters more difficult, upon imaging (X-RAY or MRI) 70-80% of cases of back pain do not have a clear biomechanical cause. In fact, many of the structural “problems” that are present on imaging are also found in people of a similar age without pain. For example, research has found that 37% of pain-free 20 year olds have signs of osteoarthritis in their spines. As we get older this number increases to 96% of pain-free 80 year olds who have signs of arthritis. There are similar findings for disc bulges and protrusions! To be clear, this does not mean your pain is in your head or made up. It just means that pain is an incredibly complex experience that depends on more than just the structure of your spine; otherwise 37% of 20 year olds would be having regular back pain!
Let’s talk about pain. If your structure (joint surfaces, disc integrity, etc) is only part of the pain puzzle, then what else is happening to make you hurt? Far more goes on in your body than an MRI can pick up. It can’t tell that the joint is stiff when you try to move it, or that the muscle around it is tight, or that other muscles are weak or have poor endurance. Additionally, high levels of stress (mental and physical) for a long enough period of time or poor sleep can increase pain and delay your recovery. This is merely a glimpse into the science behind pain but much more goes on behind the scenes in your brain before you actually know you are in pain.
So, we know that structure isn’t everything and that pain is an extremely complex and personal experience but why do I hurt? That is a difficult question and one we can’t generalize. Our physical therapists have the training and skills to help put it all together for you. We know how to assess your movement and find out what could be limiting you, while taking your lifestyle and other psychosocial factors and blending them into a cohesive plan that is customized for you! Everyone is different so your plan needs to be specific to you. We are here to help you feel good again and we do that by looking at the whole person.