Ineffective treatments for low back pain might actually make the pain (and treatment) worse.
I realize this article itself is for a medical device. However, I pulled out the parts I feel like are important. I've personally been through all the injections, tests, physical therapy.
The link for the full article is located at the bottom:
Clinicians focus on keeping the other kinds of pain from transitioning to chronic low back pain, but if it’s unreported or underreported (and in the military, it often is) or misdiagnosed, it will only get worse over time, which can lead to depression, reduced mobility, or permanent disability. A misdiagnosis can lead to ineffective treatments, which will usually be palliative, addressing only the symptoms and not the underlying cause.
Any kind of lower back injury, be it a small strain during PT, pulling a muscle while loading a pallet, or a larger one, like hitting the side of an aircraft during a jump, can lead to chronic low back pain. The multifidus muscle group next to the spine stabilizes the spine and the vertebrae. Normally, it functions almost subconsciously, getting signals from the brain to provide support for everything we do all day.
Short-term treatments for chronic low back pain
Medical care for low back pain is costly, can be time-consuming and can put some at risk of opioid addiction. There are some who even suggest mindfulness and meditation as a treatment. While that might help general quality of life for some people, it’s not going to help low back pain suddenly get better. In fact, prolonged periods of sitting can make chronic low back pain worse.
There are some drugs that can temporarily help with chronic low back pain, but none of them are intended for long-term use. Analgesic creams and anti-inflammatories are a band-aid for a much larger problem. Opioids run the user a risk of addiction and would only be prescribed if all other avenues have failed.
Pain clinics offer injections that will also help lessen pain in the short term. Steroids, ablations and nerve blocks are a few types of palliative pain treatments. Steroids carry the problem of weakening the immune system and can cause anxiety and even increase the pain. Nerve blocks and ablations simply block or deaden the nerve to prevent them from sending pain signals to the brain, but only temporarily before the pain returns and a repeat procedure with less effectiveness over time is often required.
Physical therapy is a common-prescribed treatment for chronic low back pain. It requires a definite diagnosis and has to be deployed in the acute or subacute phase of back pain to try and re-establish this muscle function. Even with a physical therapist who is trained to help multifidus dysfunction, multiple visits and the continuation of exercises at home and well into the future, cannot rehabilitate a chronic back pain condition caused by multifidus dysfunction. Even if the patient is willing to continue the exercises, the relief from physical therapy may be limited because of how deep multifidus muscles are and because they are involuntarily controlled. Patients can’t “flex their multifidus muscle” like a bicep or quadricep. The brain controls this muscle involuntarily through a process called proprioception.
Low back pain only gets worse.
For those suffering from multifidus dysfunction, it’s not just the chronic pain they need to worry about. The pain is caused by the increased workload on the spine and discs, which can cause long-term damage and permanent disability. This is particularly troublesome for military members, who are not only prone to chronic low back pain, but that pain is almost guaranteed to return if left untreated.
Most of the treatments described above will only treat the symptoms of the pain. While that may be nice in the short term, it’s important for patients to consider that there is something seriously wrong with their back muscles and time really is a factor. Not only are those treatments expensive, but they are also not treating the cause of the pain. As time goes on, the pain will be harder to address.
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