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Low Back Pain is the ‘Common Cold’ of the Spine

November 29, 2016 • Practice Leadership • Private: Mark Shepherd

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Several years ago articles on low back pain (LBP) would typically start off by stating how common LBP is in clinical practice. One of my favorite opening statements goes like this:

“Next to the common cold, low back pain is the most common reason that individuals visit a physician’s office.” (reference here, original article here)

This statement has stuck with me over the years and has helped me educate patients that LBP is common and somewhat normal to experience in their lifetime (albeit not for a sustained amount of time). The statement also expanded my thoughts on the parallels between LBP and experiencing a cold and is one that I often will relay to my patients.

If you think about it, experiencing LBP is just like experiencing a cold. When we have a cold our nose runs and becomes sensitive, we cough, our whole body might start to ache, and we have trouble sleeping. As we all know, a cold can’t be treated with a silver bullet antibiotic–we have to manage the symptoms the best we can. Isn’t this similar to what those with LBP experience as well?

If we agree that LBP is the common cold of the spine we should agree that practitioners should treat it as such. Would you want to get a MRI when experiencing a cold? How about an x-ray? What if you were told that your cold was due to a bulging booger that needed to be removed? Sounds ridiculous doesn’t it? Well this is what is happening with modern day LBP treatment. We are trying to give silver bullet antibiotics and/or costly ineffective treatments to address the cold of the spine and it just is not working.

Physical Therapy (PT) allows the patient with LBP to work through their symptoms, much like a person with cold does.

PT is the DayQuil for the common cold of the spine.

For those that are “feeling where I am coming from,” please share to others, especially patients. It is time we start looking at LBP as the common cold of the spine and stop making it anything more than that.

Mark @ShepDPT

Photo Credit: wavebreakmedia/Shutterstock.com

 

Private: Mark Shepherd

Mark is a physical therapist with nine years of experience. He is dedicated to helping students become the best clinicians they can be and is a firm believer that residency and fellowship offer critical mentorship opportunities for young clinicians. Current Roles: Program Director, Fellowship in Orthopaedic Manual Physical Therapy, Bellin College Research: Adoption of Clinical...

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––– Comments

Mike

Commented • January 6, 2020

I believe this article applies to me and my years of dealing with sporadic, debilitating back pain. Chiropractors, opioids, PT, nothing helps. I’m talking severe back spasms that will drop you to your knees. I can usually tell when I’m about to experience an episode. I will get cold like symptoms first. On my own I have found that the best management and cure is: Ibuprofen, alternating hot and cold packs, limited walking, standing, and most of all bending at the waist. In other words REST and TIME. This is just my diagnosis founded on years of experience.

Mark Shepherd

Commented • December 2, 2019

Sorry to hear about your experience with low back pain. My intent of this blog was to show how common low back pain is. Unfortunately you are not alone in this as I am sure you know. With this stated, just because it is common, doesn't mean it is "nothing to make a fuss about." You have had pain for over 15 years - there is a lot to take seriously here. Think if someone had a cold for over 15 years - the healthcare provider should definitely take the patient seriously. I hope that you find a practitioner who you trust and feel can help you out. Just know that there is hope and you can overcome the pain you have.

Silverbanshee

Commented • December 2, 2019

That's funny, Mr. Shepard... Everywhere I look, doctors are writing off back pain (and a lot of other things) as nothing to make a fuss about. This mentality is what's ruining the medical professional, and it's why fewer of us are taking you seriously. And you want MORE doctors to disregard their patient's pain? Pardon me, but I think you and your kind are monsters! I was told my LBP was no big deal for over fifteen years, despite the fact that it was getting worse and debilitating. Turns out, I have arthritis in my lower and middle back. Guess what? They still won't do anything but send me to physical therapy. NyQuil, anyone? Tell me: who's dictating this nonsense for you to pass along, or are you just an insensitive, sadist? If nothing else, you're naive. And that makes you dangerous because we think you actually know what you're talking about. Think I'll start seeing a witch-doctor. Probably get the same results, because you "doctors" aren't much better!

Roslia Santamaria

Commented • November 12, 2019

I have read your blog and you explain its so nicely. This is the best blog about "Yoga" . Thank you so much. Keep it up

Julie Riggs

Commented • January 9, 2019

Sounds like you’ve never had long-term back pain! Appropriate tests lead to appropriate care. The last thing pain patients need to hear is the belittling “it’s no big deal” of your philosophy. I’m grateful to have a doctor who takes my concerns seriously, and helps me manage my pain.

seamul hoq rubel

Commented • June 9, 2017

Good Article.The common goals of treatment are to relieve back pain and to restore mobility. Treatment varies depending on the severity and type of injury. The most common and basic treatment used for strains or minor injury is Rest.

Matt

Commented • December 2, 2016

Folks like Richard Deyo (Watch your Back), Nortin Hadler (Stabbed in the Back) and Ian Harris (Surgery the Ultimate Placebo and Dr. Skeptic) have been saying this for quite some time. Our profession, both those teaching continuing education and those in the clinic continue capitalizing on treating low back pain like something it isn't. The profession, and healthcare in general, continue treating low back pain with "stuff" when the back book, time, and re-assurance are as effective. Sounds a lot like a cold. Fritz, Julie M., et al. "Early physical therapy vs usual care in patients with recent-onset low back pain: A randomized clinical trial." JAMA 314.14 (2015): 1459-1467. I agree with every word you say. Unfortunately those in healthcare aren't ready to view low back pain as a common cold. The public isn't ready either. That said, continuing education will continue taking money from those in the profession. Those in the profession will continue throwing stuff at patients that would get better anyway. Patients will continue entering clinics for something that doesn't require treatment. So speaking of colds, I'll leave you with this. https://www.youtube.com/watch?v=gLj7fj-3L78


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