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Physicians are often thought to be the first stop for back pain, but that may not be true


Do I need to see my primary physician for my back pain?

No, contrary to belief physicians are not the provider of choice for the treatment of back pain. In other countries they act to coordinate treatment and point people to the care they need. Most of the time that is a physical therapist. PT should be the choice for care of back pain and many insurance companies want you to go to a PT first. When it comes to low back pain PT first is the best choice.


What type of care might a physician provide?

Depending on your symptoms x-ray, MRI, or blood work may all be done by their physician. Most people do not need any of these tests however and is a waste of time and money because they do not change your treatment.


Who should I go to for low back pain?

Physical therapists hit on the most effective interventions for back pain. Although other providers provide treatment that has been shown helpful for back pain PTs have a unique combination of skills. The time a therapist gives you during a session is also unique compared to chiropractors or physicians. With the most time and the largest toolbox a physical therapist has the best opportunity to reduce your back pain.


Back Pain Can Occur In A Number Of Ways

I just injured my back, but it doesn’t hurt enough to go to the doctor. What can I do?

Stay active. If you do not have a lot of pain staying active is the best solution to help you recover. If your pain lingers for more than 2 weeks to prevent long term pain seeing a physical therapist will help you further on your path to recovery.


What are the causes of back pain?

Muscles, joints, nerves, and bones can all cause pain. Usually there is combination of causes making diagnosis of the number one reason someone has back pain is difficult. A full exam from your physical therapist will help determine which structures need addressed to treat your underlying condition and reduce or eliminate your pain.

Can you know the cause of back pain?

Research suggests that only 1 out of every 10 people ever know the cause of their back pain. This is because imaging has been found to not help determine the cause of pain and pain tends to have multiple causes. This makes it difficult to determine the underlying cause. This is because we are not sure if the chicken or the egg came first, we just know we need to address both of them.

You Should Question What Tests You Actually Need For Low Back Pain


Will I need to have tests done?

Most people with back pain do not need extra tests done. Unless you have had a fall, have a rapid loss in strength, or have loss of sensation further tests will not help determine what you need to recover. A full examination will help determine what you need to recover. X-rays and MRIs do not help determine what intervention you need.

What is a herniated disk or disk bulge?

A herniated disk is a disc where more than half of the disc has bulged and a crack has formed that allows for a part of the disc to move out into the spinal cord. A bulging disc is one that is less than half the perimeter and no crack has formed. An acute disc herniation can be painful due to the material moving but does recover given time. If you have pain for more than 3 months it is unlikely the herniation is the root cause of your symptoms.

Will the pain come back?

Most people have pain return. 60-80% of people with a history of back pain will have it again. This is why developing strategies to help you long term is key. If symptoms do return this will allow you to control your symptoms when they do return.

I was told my back is the the worst the physician has ever seen, is it hopeless?

This is a more common statement than you may think. If you do not have signs that would indicate surgery then this only means there is a lot of things on your MRI or x-ray. This does not mean that you can not improve or eliminate your symptoms. Especially if your pain is recent the image is likely not a good representation of your spine health. Therapy can help even the “worst” spines and get you on track to recover.

I was told my spine is the spine of a much older person. What can I do?

Every spine is unique. Just as with our face we get wrinkles on the inside. These can include degeneration, “slipped”, herniated or bulging discs, arthritis,, spondylitic changes, and other seemingly bad changes. However people without pain have these same changes. The important thing to do is to remain active. When we decrease our activity levels for more than a few weeks we tend to have more poor in the long term. The most active people tend to have the most arthritis. When you see a physical therapist they can help you gradually get back to, or begin new activities despite these wrinkles on the inside.

Should I get a second opinion if someone has recommended surgery?

There are situations where surgery is an emergency. These include, but are not limited to, a rapid loss in strength, numbness in the groin, or an inability to urinate. If you do not have any of the symptoms above you should get a second opinion. There is often enough on an image in a healthy person without pain that a surgeon could “fix.” This means what they want to operate on may have nothing to do with your pain and could only make you worse in the long run.


 Even With Low Back Pain You Can Exercise

Should I stop exercising due to my back pain?

If you are able to exercise but pain gets worse and stays worse for more than 30 minutes after you stop exercise needs to be modified. A physical therapist can help with this modification to get you back to exercise faster. Graded exercise, or exercise that is gradually increased from a tolerable amount, is effective in reducing back pain.

Is back pain normal?

Back pain is very normal. Like death and taxes back pain nearly happens to everyone. About 10% of adults have persisting low back pain. 26-30% of people have had back pain in the last 3 months.

How many people have back pain?

Most people have either had or will have back pain in their life. About 60-80% of people report back pain at some point in their lives. 10% of adults have persisting low back pain. As one of the largest health care expenses low back pain is number 2 only to the cold/flu for visits to outpatient healthcare providers. Back pain is very common.

Should I be concerned about my back pain?

90% of low back pain resolves within 6 weeks. Of these people however 60-80% have back pain return. This means that if you do not address your back pain it is likely to return and get worse. To prevent this having a short stint with a physical therapist can help you get lifelong control of your symptoms.


 Nerves Are The Reason We Have Tingling And Numbness

I have tingling what should I do?

Tingling in the groin where you would sit on bicycle seat with loss of sensation and/or the inability to use the bathroom is an emergency condition and you should go to the hospital to rule out dangerous conditions. Tingling in the groin should be addressed to determine why the nerves are irritated. Other tingling tends to relate to nerve irritation and a physical therapist can address the tingling.

What causes numbness and tingling in the upper or lower limbs?

Irritation of nerves is a primary cause of tingling. This tingling can be due to compression, trauma, or tension and can occur anywhere along the path of the nerve. This means the tingling can be due to irritation in the spine, joints along the way, or general sensitivity of the nerve. There are a number of reasons for this to occur and a full exam is the only way to determine your specific issue.\

What is the difference between tingling and numbness?

Tingling is a pins and needles sensation or an electric feeling. Numbness is a complete loss of sensation. If you are able touch the area and do not feel it the area is numb. This is not uncommon over scars but when you lose sensation over an area you had sensation you need to see a provider quickly. Numbness needs to be monitored and addressed to prevent it from becoming worse or other issues arising. Both issues are due to nerve problems which can be addressed by a physical therapist.


 Physical Therapy For Low Back Pain Is Cheaper Than The Other Options

How much does it cost for treatment of low back pain?

Treatment for back pain is determined by who you go to first. For back pain when people go to physical therapist first they save between 1,000 and 3,000 dollars compared to going to a physician first. This cost is on average. A comprehensive exam and treatment at Ascend Orthopaedics can save you $100’s.

Does popping my back hurt my back?

There is no evidence that popping your back hurts your back or gives you arthritis. Popping is thought to be a vacuum effect. Just like the noise you hear when you pull a suction cup off a fridge the space that is created causes the popping to occur. People used to think this pop was due to a bubble popping but it is more likely that it is the formation of the bubble or space that causes the sound.

What can I do to prevent back pain?

Stay active. It may sound simple but people who are active and move more tend to suffer less from back pain. Braces and other equipment have not been found to help overall. An ergonomic set up at work and limiting your time sitting can help as well. When it comes to back pain motion is lotion which is a big reason why people who go to yoga when they have back pain tend to feel better.

 Climb The Stairway To Recovery From Low Back Pain

Can my back pain get better if I have had it for years?

Absolutely! This is a common myth that people can not feel better when they have been in pain a long time. It is less likely your back pain will go away and never come back but people with at least 2 years of back pain were treated with physical therapy and a gradual increase in their activity they saw a 30% reduction in their symptoms. This meant they could walk further, had less pain, and overall did more than people who did not receive treatment.

Will my back pain ever go away?

Most people recover fully from low back pain. 90% of people see full recovery within 6 weeks. If you have had long standing back pain it is unlikely your pain will go away with any intervention however physical therapy has shown able to shift your pain. This can help severe pain become moderate pain and moderate pain to become minimal pain. Developing strategies, understanding your pain, and a graded recovery approach are key to improve chronic back pain.

Does age affect back pain?

As we get older there are more reasons for us to have back pain. As a common ailment the older we are the more likely we are to have an episode of low back pain. Natural changes to our body do not appear to be the reason for our pain however. Change in our activity level and our general health may play a larger factor in if we experience back pain. This is why exercise consistently helps low back pain improve.


 There Are Many Questions About Low Back Pain

Why do I still have back pain?

Back pain can linger for a number of reasons. This can be due to your strategy for recovery. Rest for instance does not help for more than a day or two. If you have symptoms such as fever, weight loss, unable to urinate, history of cancer, and pain at night that does not change by position you need further work up and to be seen by a health care provider. The key for back pain is to make sure you do not have something dangerous and then find the strategy that works best for your symptoms to recover.

What can I do to prevent my back pain from getting worse?

Back pain gets better over time with the right direction. If you take it easy for a day or two then gradually get back to your normal day to day routine you should expect to feel better. If you continue to struggle and your back pain becomes worse you will need extra help. Physical therapy can help. At Ascend Orthopaedics we can help you develop the strategies you need to prevent the pain from getting worse and to start improving.

My parents had back pain, am I doomed to get back pain too?

You are more likely to have back pain if you have a family member with back pain. Although we do not know why this is, it appears that low back pain may run in families. There is an increase in risk for low back pain in people with an immediate family member with low back pain. How severe the low back pain is however has not been studied. As many people with back pain recover within a few weeks there is no reason to have major concern about low back pain and if it were to occur.

Is my back and hip pain related?

Back and hip pain typically go together. The term is hip/spine syndrome. Treatment to both areas tends to be key to recovery. Back pain can also refer to the hip and hip pain will not go away until you get the right treatment for you back pain. Whether you have back pain, hip pain, or both an exam to assess the entire area is key to eliminate your symptoms and prevent recurrence of symptoms.

How does stress affect back pain?

Stress is associated with low back pain. In a number of studies perceived stress and  overall stress contribute to back pain. It has also been found when you take the steps to treat their stress will see better recovery for chronic back pain compared to usual treatment. This means that support to manage stress and treatment for stress can help reduce or eliminate your pain.



Have other questions about low back pain let us know!



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