5 Self-Treatment Mistakes That Keep Your Back Pain Coming Back

I’ve said it many times, but I think it is worth saying again - Back pain (Lower Back Pain, Lumbar Pain, Chronic Low Back Pain) is a global epidemic. As many as 80% of adults will experience low back pain at some point in their life. And because of the amount of misinformation and treatment approaches due to the internet and social media, treatment options for low back pain have become more overwhelming than ever. The amount of inaccurate or surface level information at our fingertips can be frustrating because the generic treatments you find may not target the nuances of your low back pain - potentially leading to either recurrent or chronic low back pain.

And while it is on my mind, since I just typed it, what is the difference between Recurrent Back Pain and Chronic Back Pain? 

Isn’t that the same thing? Not Exactly. 

Recurrent back pain is back pain that comes and goes. This is the back pain that lulls you into a false sense of hope because you feel you have finally kicked your back pain - only for the pain to come back a few months - or even years - later. 

Further making recurrent back pain difficult to self-treat is - when back pain comes back months/years later, there is no guarantee that the source is the exact same. Compensatory patterns from the previous bout of back pain may have caused an imbalance at a neighboring joint/structure. This can be frustrating because the exercises that previously worked may not work for the recurrent version. 

In my experience, many people who struggle with recurrent back pain have never gotten a solid explanation on the actual source of their injury. Thus, you may not know how to avoid future exacerbations or what your triggers are. 

Chronic Back Pain, on the other hand, is pain that persists for roughly 3 months - although there is no magic moment that pain is labeled chronic. Chronic back pain can turn into recurrent back pain if the symptoms finally subside but then return a few months later. 

And as always, anytime I am going to write about a specific injury or topic, I think it is paramount to discuss the relevant anatomy so we are on the same wavelength. 

Quick Anatomy Review of the Lower Back

Depending on how you initially sustained your back pain - ranging from lifting in the gym, repetitive twisting with housework, falling, a car accident, prolonged sitting occupation, or many many more causes - these movements/injuries create different amounts of stress to a variety of structures, resulting in many potential injury sources.

To simply list out some common sources of lower back pain:

• Joint / Facet Dysfunction

• Disc Injury (Bulging versus Herniated)

• Ligament Sprain

• Muscle Strain

• Fascial Injury

• Nerve Root Injury

• Bony Fracture

• Instability 

Each of these above structures/causes can present varying levels of pain and dysfunction, and each source above is treated with subtle - yet important - differences. Different structures will respond uniquely to movements and applied stress, making lasting pain relief difficult when generic treatment is administered. 

For example, lying on your stomach may feel better for some disc-related injuries to the lower back - but this may increase pain if the facets/joints of the lower back are inflamed/injured. 

This brief anatomy review and example is a perfect example on why a thorough Osteopractic Physical Therapy Assessment is vital in finally kicking your back pain - but more on that later. 

As previously mentioned, back pain is an epidemic and I routinely field both phone calls and new patient evaluations for all iterations of back pain. 

And despite each patient having unique components to their story, I have heard many similarities from thousands of patients over the years. 

So let's take a look at the 5 Biggest Mistakes I have seen time and time again over the years:

Treating Back Pain with Rest and Medication

I don’t blame you for taking time off and lying down in your bed when you have sudden back pain or an exacerbation in back pain. But the truth of the matter is, the longer you lie in bed, the risk increases for the back pain to progressively worsen. 

Additionally, while potentially binging the next great television show on Netflix, you may be tempted to take over the counter pain medication to address your symptoms. 

This creates a slippery combination of inactivity and medication that can directly lead to Chronic Back Pain. 

Unnecessary Imaging Studies

I have assessed many patients with lower back pain who immediately had an X-Ray at an urgent care or emergency room - only for the findings to be insignificant  - and then given instructions to take it easy and a prescribed medication (see above mistake #1).

This immediately creates confusion because you know you are in pain - you can feel your back pain - but you are somehow told that nothing is wrong because the X-Ray was negative. But they forget to mention that the X-Ray doesn’t show the majority of potential pain sources - and to put it bluntly - an X-Ray doesn’t treat the injury or provide real relief.

The other side of the coin is when you have sudden back pain and your X-Ray Report says you have Degenerative Joint Disease (I hate when my patients are told this - because it is never explained correctly - but that is a completely different soap box). I can assure you, if you have DJD/Arthritic changes, it didn’t occur in the past week and has likely been present for months/years without any symptoms - indicating that you can live a symptom free, active life with normal degeneration of a weight bearing joint. 

Ignoring Hip Pain or Knee Pain

After I give my patients the time to explain all of the nuances of their back pain to me at the beginning of their assessment, I typically ask a blanket question of “Is there anything else you would like me to know about or assess?”

And so many times the patient will say “Well, actually I have this strange pain in my hip (or knee) sometimes but I’m sure it’s not related, right?”

They are likely very much related. And this is why, even if you don’t mention hip or knee pain to me in your opening statements, I will definitely ask about this specifically as well as assess the hips and knees when you come in for back. 

I assess and address the hips and knee because in order to fully assess and treat the lower back - you can’t exclude the hips. 

So if your hips or glutes have been feeling achy or tight, and you can’t quite stretch the pain away, then it is likely connected to your pesky recurrent back pain.

Which leads me to the next mistake…

Stretching every day to try to keep the back pain away

“I have been stretching my hip flexors and piriformis for years to keep my back pain away…but the pain always comes back…stretching feels good but the relief is temporary.” 

This is a repeating conversation I have with my patients regarding their lower back pain. You can’t stretch away pain if the source of the pain/tightness isn’t a muscle. 

There may be a muscular component to your pain, but if that is simply a secondary issue stemming from the root of your back pain, then stretching likely won’t solve your back pain conundrum. 

Not to mention, overstretching the muscles in the hips or lower back can lead to muscular weakness and further increases your chances for recurrent back pain. 

Performing Generic Exercise Programs that don’t target the actual source of your pain

And lastly, and probably the most important concept for finally breaking the cycle of recurrent back pain, is to stop doing generalized exercises and generic treatments for a very specific injury. 

As noted above, there are a litany of structures that can cause recurrent back pain or chronic back pain, and each structure requires specific intervention to maximize pain relief. 

Oh, and stop doing core exercises - they won’t fix your back pain - and in all likelihood may play a role in having back pain in the first place.

Are you tired of your back pain coming back? Looking for bona fide help? What Next?

Well guess what Acadiana!? If you are in Lafayette, LA - and surrounding areas - you have an Osteopractic Physical Therapy clinic at Flow Physical Therapy and Wellness right in your backyard to help you navigate your recurrent or chronic back pain.

Our Fellowship-Trained, Osteopractic Physical Therapist will spend a minimum of 60 minutes of one-on-one uninterrupted time with you at each session to provide the hands-on treatment specific to your unique version of back pain. 

Whether that treatment calls for spinal manipulations (adjustments), joint mobilizations, strengthening, corrective exercises to address biomechanics, dry needling, cupping, scraping, or any combination of the above, you can be certain you will not be receiving generic treatment that is the same as any other patient with “back pain.”

If you are ready to finally kick your recurrent back pain or you are tired of your chronic back pain, click the button below to schedule your initial Osteopractic Physical Therapy Assessment. 

Not ready to commit to Formal Physical Therapy Services? But you need trustworthy information on back pain, Click Here for The Active Adult's Free Cheat Sheet for Finally Beating your Back Pain!

Dr. Patrick Thompson, PT, DPT, OCS, Dip. Osteopractic, FAAOMPT

Owner of Flow Physical Therapy and Wellness

337-366-1703