Why is the back such a problematic area of the body?

More than half of people say they've suffered lower back pain in the past year, according to the latest NPR-Truven Health Analytics Health Poll.

That's not a surprise; low back pain is very common, and one of the biggest reasons that people seek medical care. But people told us that they're making very different choices in how they treat that pain, with some stark differences among age groups and income levels. Doctors often aren't giving people advice based on the best medical evidence, instead prescribing treatments that don't relieve back pain and can expose people to serious risk, including addiction.

Statistics show that back pain places second in hospitalizations and hospital visits just behind childbirth. In the United States, 4 out of 5 people will experience back pain at least once in their lives, and many live with it every day. It costs more in downtime per capita than any other problem. It is the leading cause of missed work and disability worldwide.

Thirty-one million Americans experience low-back pain at any given time. The prevalence of chronic, impairing low back pain has risen significantly over the past 16 years in a study done between 1992 and 2006, and after contacting over 10,000 individual households, it was determined the percentage of the US population suffering from chronic low back pain increased from 3.9% in 1992 to 10.2% by 2006. Increases were seen for all adult age strata, in males and females. This is a 261% increase in the United States alone.

What could the causes be?

While a single source for the drastic increase in back pain sufferers in the United states may not be fully isolated, back pain can be caused by a variety of issues. Strained muscles and ligaments, heavy lifting, a sudden twisting movement, or more severe structural conditions such as bulging or ruptured disks, sciatica, arthritis, osteoporosis and scoliosis.

Assuming the treatment that each of these physicians would do:

An Orthopedic Surgeon or Neurosurgeon would probably first think surgery.This is what they do after all. Surgery is invasive and can be dangerous. According to Dr. Chris Centeno, MD, in his September 14, 2016 article in Regenexx: “There are many ineffective surgeries out there, and the useless orthopedic surgery list is among the longest as I would estimate that about half of all elective orthopedic surgeries being performed have been shown to be ineffective based on the research.”

Medical Doctors generally first consider a way to stop pain, and their solution is usually to prescribe a painkiller. They may prescribe physical therapy or an NSID, (over the counter drugs). The odds are that they would prescribe something much stronger, such as Oxycontin, Oxycodone, or Fentanyl, and while they do produce a decrease in pain, this form of “therapy” is only masking the problem, and often times creates new problems for the patient (as these types of medications carry heavy side effects.) A conscientious doctor would use a different method by referring the patient to a physical therapist, Orthopedic surgeons, if severe enough, or in some cases, to a Chiropractor and even possibly to get a brace.

A Physical Therapist treats patients by teaching them different exercises intended to strengthen or stretch muscles as well as alleviate pain. Their philosophy is akin to that of Chiropractors, for they are against drugging and rely on exercising, putting the body through a range of motions or massaging the tissues. A Physical Therapist “wakes up” the tissues in the area and they will then be able to go to work doing their job.

Chiropractors use hands-on spinal manipulation which aligns the body' s musculoskeletal structure, particularly the spine, and will enable the body to heal itself without surgery or medication. This process also “wakes up” the muscles and tissues. To assist in the healing process, bracing is frequently used to shift the load from the injured or sensitive areas to more competent structures while the tissues are allowed to heal without the burden and stress of daily activities.

This brings us to the subject of bracing and most specifically, a Lumbar Sacral Orthosis Back Brace.

Lumbar support devices provide enough compression and support for the lower back to provide a patient with relief and paves the way for healing to occur. The compression on the abdomen means there’s less pressure on the patient’s lower back discs, ligaments, muscles and spine. This decrease in pressure, in the majority of cases, results in an immediate decrease in low back pain for the patient, without the need for a pain medication.

Lumbar braces typically fit around your waist and are secured with Velcro. They often have a steel or plastic plate attached to the section that would press against the patient’s lower back to provide support. Some have over-the-shoulders straps, but this is not usually necessary.

There are 4 approved reasons for medical necessity for an LSO back brace, so if your patient meets one of these four points they may qualify for one of these braces.

1. To reduce pain by restricting mobility of the trunk.
2. To facilitate healing following an injury to the spine or related soft tissue.
3. To facilitate healing following a surgical procedure on the spine or related soft tissue.
4. To otherwise support weak spinal muscles and/or a deformed spine.

People who suffer mild to moderate sub-acute back pain should begin wearing a back brace as soon as their discomfort sets in. One who is prescribing will want to supply the patient with a brace so that they can move. Inactivity or immobilization is the worst thing for a back. A patient will want to remain active, and a brace can help them do that.

How can wearing a brace help?

Some studies have shown that wearing a lumbar support device could lead to negative effects, such as skin lesions, muscle wasting or higher heart rates. Those issues are rare and typically occur with people who wear a back brace for an extended period of time and are inactive during this time period, while not progressing with any other form of treatment.

The purpose of a back brace is not to treat or correct the patient’s back problem. The purpose of the brace is simply a short-term solution for the patient’s pain and to provide them with the support to keep them active and moving. Bracing must be used in conjunction with treatment to correct the underlying issue.

Chiropractic manipulation is a long-proven solution for correcting these types of underlying issues. As well as physical therapy and rehab. Ideally a patient would receive all three, a back brace for immediate relief and support, Chiropractic manipulation to correct the issue, and physical therapy and rehab to strengthen weak or atrophied muscles that may have contributed to the condition or may exist as the result of an injury.

If a back-brace fits well, is worn properly – that is, it's not too snug – and is not overused, it shouldn't create any health problems. Upon being interviewed one doctor said “During the course of his 30-year career, hundreds of his patients have worn lumbar support devices. None of them developed any problems, aside from a handful who had minor skin irritation where part of the brace rubbed their body.” He remedied that issue by having his patients wear an undershirt between the lumbar support device and their skin.

"Just this past week I slipped down the stairs and my back went out! I was in so much pain that I didn't leave my house for two days. How could I go back to work? I wouldn't even be able to perform the basic functions of my job. I was just about to request a leave when my doctor issued me an LSO back brace.

WOW! What relief! As soon as I put the brace on I could stand again with no pain. I could move around with ease. I was even able to go back to work without missing any days!

I'm so thankful that I was issued that brace. It has really sped up my recovery. It's also saved me hours of unnecessary pain and lost time and money by allowing me to go back to work."

-C.J.

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