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The Skinny on Back Pain: What Does Work and What Doesn't Work
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The Skinny on Back Pain: What does Work and What Doesn't Work
By Patrick Roth,
Author of The End of Back Pain: Access Your Hidden Core to Heal Your Body

At any given time 20% of us have back pain
During the last year, 40% of us have had back pain
Throughout our lives, 80% of us will have had back pain

Recent reviews suggest that more and more back pain sufferers are using our healthcare system to diagnose and treat their pain. (more than 20 million visits per year)

We are spending more money on back pain while disability from back pain increases.

In order to understand this, you must understand that back pain and disability from back pain are separate phenomena. Back pain doesn't change. If you took an arbitrary poll anywhere in the world today or even if you travelled back in time and took that poll, you would find that the above percentages consistently apply.

Polling disability as a result of that back pain, in contrast, would vary wildly. It is largely a peculiar phenomenon of westernized cultures.

Part of the reason that our system fails us is that we are inundated with a slew of harmful myths. These myths set a destructive tone and lead us astray.

What doesn't work:

1. The status quo. When you see a healthcare provider, the treatment you receive is based on what that provider does and not on what is wrong with you. (ie when you see a chiropractor, you receive chiropractic. When you see a pain management doctor, you get an injection. When you see a surgeon…. You get the idea!

2. Assuming that back pain arises from something "broken". Back pain is seldom the result of an injury. It should be regarded as "part of life" like a cold or a headache. It can improve without being "fixed"

3. Letting "pain be your guide" as you increase activities. We are programed to interpret pain as natures warning sign. Although this it true at times, most of the time, adherence to this philosophy leads us to improve more slowly and less completely than we would otherwise be capable of.

4. Altering your work environment or the physical demands of you job. This "common sense" principle does not predictably lead to a decrease in pain or disability.

What does work:

1. Don't assume that your health care provider knows what is best for you. Their advice is often self-serving and not in your best interest. It is up to you to be circumspect and to question the validity of every proposed treatment. If it seems wrong for you, it probably is. Back pain is your responsibility.

2. Remember that back pain usually gets better. The natural history of acute back pain is typically one of improvement. Remember, also, that back pain tends to recur. It is essential that you engage in an exercise program for your core that will limit the frequency, duration, and intensity of the exacerbations.

3. Harness the remarkable ability of you body to adapt. Begin to increase activities and exercise even while still in pain. Yes, you can have setbacks, but patients much more often "underachieve" rather than  "over do it". Be willing to put up with some pain as you return to full activities.

4. Focus on enjoying your job rather than changing your work environment. Increasing your job satisfaction is more likely to result in decreased disability than is a thorough ergonomic overhaul.

Do you see the common theme here? Back pain is your responsibility. You can't make it go away, but you can reduce the associated disability. You can also mitigate back pain by reducing the frequency, intensity, and duration of the inevitable recurrences. Try these 3 simple exercises below three times a week to strengthen your core and improve your back pain.

"Bird dog"

This is an endurance exercise. Make gains by increasing the number of repetitions with good form.


This is an endurance exercise. Make gains by increasing the time held with good form.

Side plank

This is an endurance exercise. Make gains by increasing the time held with good form. Remember that you have two sides!

© 2014 Patrick Roth, M.D., author of The End of Back Pain: Access Your Hidden Core to Heal Your Body

Author Bio
Dr. Patrick Roth
, author of The End of Back Pain: Access Your Hidden Core to Heal Your Body, is a board-certified neurosurgeon in New Jersey and the chairman of neurosurgery at Hackensack University Medical Center. He is the director of the neurosurgical residency program and is dedicated to the teaching and training of future neurosurgeons. He is a founding member of the North Jersey Brain & Spine Center.

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