Low back pain is one of the leading causes of disability worldwide. Every individual case is unique. A cause and effect relationship is often difficult to determine. Moreover, treatment strategies and pain management vary widely based on the medical practitioner consulted.
As a result, many guidelines have been developed to help guide practitioners to management strategies which have been proven effective through research. Equally, as a patient it is particularly important to understand your diagnosis and treatment options, and become an active part of your own treatment and rehabilitation team.
Effective or Recommended Treatments:
- Obtain an assessment from a spine specialist (Medical doctor, Chiropractor, Osteopath, Physiotherapist).
- Become educated about the nature of pain and how to cope, lifestyle, nutrition, activity.
- Spinal manipulation for acute and chronic low back pain can be an effective treatment.
- Manual therapy can help with relaxation, flexibility, and pain relief.
- Exercise or encouragement of activity. Or encouragement to return to activity for acute and chronic low back pain.
- Reassurance and instruction on self management options from a licensed and regulated medical professional.
- Multimodal treatment including counselling and or cognitive behavioural therapy for chronic low back pain or patients with psycho social risk factors.
- Acupuncture or massage therapy in combination with other active treatments.
- Re-assessment or referral for patients whose symptoms do not resolve or change.
- Imaging if any red flags present with radiculopathy (symptoms in the legs).
- Using medication if it’s right for you, always talk to your doctor and pharmacist about options for you.
- Acetaminophen, NSAIDs (Non-steroidal anti-inflammatories) or paracetamol.
- Opioids when necessary.
- Prevention: exercise/physical activity.
- Yoga therapy: vinyasa types have been proven effective.
- Aquatic exercise have also been proven effective.
Treatments: possibly effective/unknown:
- Prevention: spinal manipulation or mobilization.
- Prevention: chairs, mattress recommendations.
- Injections (talk to medical doctor about these options).
Treatments: not recommended:
- Bed rest.
- Diagnostic imaging, particularly, acute low back pain with no red flags.
- Any passive modality as the only treatment modality.
- Traction as only treatment modality.
- Prevention: using lumbar supports.
- Prevention: wearing orthotics.
Overall, if you are suffering from low back pain do not hesitate to consult a licensed and regulated medical professional. Additionally, prepare a list of questions for your appointment and do not hesitate to ask them.
- Wong, J. J., Côté, P., Sutton, D. A., Randhawa, K., Yu, H., Varatharajan, S., … & Carroll, L. J. (2017). Clinical practice guidelines for the noninvasive management of low back pain: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. European journal of pain, 21(2), 201-216.
- Bronfort, G., Haas, M., Evans, R., Kawchuk, G., & Dagenais, S. (2008). Evidence-informed management of chronic low back pain with spinal manipulation and mobilization. The Spine Journal, 8(1), 213-225.