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This article will go over how to approach back pain. Every person’s situation is unique, and this article should in no way take the place of medical intervention and or the diagnosis/treatment process.
Back pain and other similar physical pain tend to be the result of numerous factors. One dealing with pain should seek advice from multiple treatment systems. BARUCHealth addresses pain from a broader perspective than one single specialized system (systems such as surgical intervention, prescription medications, physical therapy, massage therapy, chiropractic therapy, corrective exercise, self-therapy, etc.).
An Overview
Dealing with back pain should be done systematically.
This article will give a step by step approach to improving or eliminating back pain. The 5 steps for dealing with back pain are… Step 1: Figure out how it started. Step 2: Decide how to treat it. Step 3: Give the plan a chance. Step 4: Assess the approaches effectiveness. Step 5: Transition from pain management to general care and everyday living/training.
This article will also explain how the “Rule of Invasiveness©” applies to back pain.
“You don’t know what you don’t know.”
Unfortunately, back pain is one of the most common physical ailments people have. Because back pain is so common there are many different systems for assessing, diagnosing and treating back pain. This naturally creates a problem because a person with back pain could potentially be given five or more diagnosis/treatment plans.
Taking a step back, we have to acknowledge that practitioners diagnosing and treating back pain are fundamentally operating businesses. This means that when a person sees (for example) a chiropractor, the diagnosis may simply be the best possible assessment using the tools accessible to a chiropractor. And even tho the chiropractor’s intentions are “good” they are motivated by helping (taking on new patients), even when they are not the best practitioner to help.
This is where the “Rule of Invasiveness©” comes in. The “Rule of Invasiveness©” states that one should seek as much possible information about their physical condition in order to formulate a treatment plan. This plan must begin with the least invasive method of treatment and only use a more invasive method when the lesser invasive method proves unsuccessful at eliminating the symptoms.
The methods of diagnosing/treating the body’s current state are:
*In order from most invasive to least invasive.
1st. MRI & X-Ray (Surgical Intervention)
2nd. Manual Therapy
3rd. Rehabilitative Exercises
4th. Self-Therapy Protocols
5th. Rest
The Rule of Invasiveness can be thought of as a circle.
With that said, by first completing more invasive methods of diagnosis you rule-out more invasive methods of treatments. But often times a lesser invasive method of treatment is started and then proves ineffective, but the practitioner does not recommend a more invasive method of diagnosis and potential treatment. This could be a personal trainer who thinks you do not need manual therapy or a manual therapist who does not think you need surgery, etc.
Examples of how this plays out in the real world are…
Without an MRI or X-Ray:
– Bone fragments are impossible to detect.
– Bulged discs are objectively impossible to detect.
– Scoliosis / Kyphosis is impossible to measure (and can depend dramatically on the posture taken during the imaging process)
– Nerves atypically placed that cause regular nerve innervation, i.e. pain, are impossible to identify.
– and many other situations which are impossible to diagnose.
Without Manual Therapy:
– Inflamed, tender and swollen areas are not assessed.
– Guarded areas are not detected.
– Tense muscles are not detected.
– and many other passive and active physical conditions that can only be detected by touch.
Without Rehabilitative Exercises (Movement):
– Weakness, tightness, and immobility of the body cannot be assessed.
– Balance and coordination can not be assessed.
– Current range of motion can not be assessed fully (without the active participation of the person).
– additional active and passive components of structural integrity of the body cannot be assessed.
Without Self-Therapy:
– You will not be certain if treatments like ice, heat, self-massage, natural remedies, and other home care methods will both uncover your problem area and eliminate the symptoms.
Without Rest:
– You will not give your body a chance to heal itself.
To reiterate, in order to gather the most amount of information about your physical condition, you would need an MRI and X-Ray completed. With the information from an MRI and X-Ray, you will be able to rule out surgical intervention and thereafter seek less invasive diagnosis/treatment, such as manual therapy, rehabilitative exercises or self-therapy and rest.
*This does not mean you will always need an MRI or X-Ray the moment you have back pain, this is meant for those who have been suffering from symptoms for weeks, months or years and still have yet to successfully eliminate their back pain.
In a perfect world, you will be able to deal with your pain as follows….
Step 1. Figure out how it started.
Step 2. Decide how to treat it.
Step 3. Give the plan a chance.
Step 4. Assess the approaches effectiveness.
Step 5. Transition from pain management to general care.
Step 1. Figure out how it started.
Have you experienced a sudden and traumatic event?
Do you have chronic back pain (with symptoms more than 6 weeks?)
Have you experienced sudden acute pain from a non-traumatic event?
You will need to approach your back pain differently depending on what situation you are dealing with. Generally, pain that is caused by a traumatic event should be assessed as soon as possible by a physician that has access to MRI and X-Ray.
Pain that is experienced suddenly from a non-traumatic event generally can be approached using the Rule of Invasiveness’s treatment steps. This means starting with rest, then escalating to self-therapy (such as ice), then escalating to rehabilitation exercise (such as gentle stretching), then escalating to manual therapy (such as massage or chiropractic) and then escalating to an MRI or X-Ray (in order to potentially undergo surgical intervention).
Chronic back pain that has persisted more than about 6 weeks should follow the Rule of Invasiveness’s diagnosis steps. Meaning, meet with your physician who can potentially order an MRI or X-Ray to understand fully what is going on. This is necessary because it is common for people suffering from chronic back pain to need either surgical intervention, or to find out that complete bed rest is necessary, or to avoid certain forms of therapy (per the reasons earlier in the article).
Step 2. Decide how to treat it.
This step depends on what you have found out in Step 1. There are countless ways to treat your back pain. But generally, as long as you do not need surgery you should follow the Rule of Invasiveness’s treatment order. The order is first rest, second rehabilitative exercise, third manual therapy, fourth surgical intervention (medicinal medication).
Again, your very first step should be connecting with your general physician to rule out the need for an MRI/X-Ray and potential surgical intervention. From there let your body rest, this could mean staying home from work and or stopping all physical activity. If rest does not work to resolve your symptoms then escalate to the next level of invasiveness, listed on the Rule of Invasiveness’s treatment steps.
Step 3. Give the plan a chance.
This step is crucial and where many people fail. Too often people do not give a plan enough time to work. This means they either do not rest long enough and immediately think they need to be stretching (moving) or receiving manual therapy. This also happens when people do not follow the plan at all. This lack of compliance is a major failure for people.
Step 4. Assess the approaches effectiveness.
This is also kind of like asking yourself or your provider when is the right time for a second opinion. This second opinion means you may need to escalate your treatment method. This is the opposite of not giving your plan a chance to work. Often times someone dealing with pain will come to trust their provider’s opinion and forget that the provider is only able to treat based off of which diagnosis they are capable of providing. Therefore if after one to three appointments with a practitioner you do not feel relief it is possible that the method of treatment will not help your specific case.
Again, most pain that does not happen from a sudden traumatic event will resolve with rest, ice and gentle stretching (movement). And pains that are the result of a traumatic event that do not require surgical intervention will typically resolve or greatly improve within 6 weeks. This means if you have followed a treatment plan for 6 weeks with little to no improvements, it is likely time for a second opinion.
This is also a time, to be honest with yourself and assess your own compliance with the plan. It is common for those in pain to shift the “blame” to the plan and not their own lack of compliance. This is a natural result of the western way of thinking that someone should “fix me”, and the quick fix mentality, and the “there is a pill for that” way of not taking an active role in maintaining one’s own health and well-being.
Step 5. Transition from pain management to general care.
This is another crucial transitional point. At some moment in your plan, you will feel good enough to move on. This may mean stopping your period of rest, stopping rehabilitative exercises, or stopping regular manual therapy. This is when you need to ask yourself, what type of physical training program can you follow that will prevent this from happening again.
BARUCHealth offers a free Training Program that is progressive enough for those recently leaving pain treatment. You can start at this link https://www.baruchealth.com/movement-path-1/
In Closing
Back Pain (and all pain) is very individual. No two people will experience identical pains and no two people heal the same way. The point of this article is to equip someone (with back pain) with a general overview and way of approaching how to receive help and treatment. There are many options out there for someone in pain, and it is important to never let yourself become a victim of a practitioner preventing you from seeking a second opinion and alternative form of treatment. Not everyone is playing at the same level and with the same information. By using the “Rule of Invasiveness©” you can be more in control of your treatment and pain.
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All the very best,
Dan Baruch
BARUCHealth: Founder
info@baruchealth.com
BARUCHealth Programs For Health Vitality & Performance
Step By Step Programs:
Nutrition
Movement (Training)
Self-Therapy
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