WHAT CAUSES LOW BACK PAIN TO BECOME CHRONIC?

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WHAT CAUSES LOW BACK PAIN TO BECOME CHRONIC?
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Low back pain is the leading cause of disability
in the US and the world. Treatments for back pain
have escalated to the most expensive medical
problem. Why do some experience back pain for
just a few days while others develop chronic
symptoms and even disability? A recently
published research article looked into this very
question. Researchers found that 32 of those
with low back pain go onto have lingering or
chronic symptoms. This large prospective study
then went on to outline the contributing factors
that lead to prolonged symptoms. The risk of
transition to chronicity was associated with
early care not aligned with current practice
guidelines.
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• Evidence-based practice guidelines for the
  treatment of low back pain include the following
• Early access to proper care that includes
• Mechanical Assessment to determine directional
  preference.
• Care that focuses on patient education,
  empowerment, and functional activity.
• Advice to stay active and at work, as able.
• Psychosocial factors are assessed and addressed.
• Screen for any red-flags and provide appropriate
  referral/ further testing.

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• Non-Guideline Care that increases the risk of low
  back pain becoming a chronic condition
• Pain medications including opioids
• Passive care
• Referral to a specialist
• Radiographs (x-ray, MRI, CT Scans) unless
  indicated to rule-out red-flags / pathologies.
• The data found that 48 of those with LBP
  received at least one non-guideline treatment
  within three weeks of their initial visit or care.

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• Specifically
• 30 received prescriptions for non-recommended
  medications (65 opioids)
• 24 received radiography (MRI/CT scan)
• 6 referred to a specialist
• When are we going to change these common and
  harmful protocols?
• Those with low back pain should first be screened
  and treated by a musculoskeletal specialist.
  Further testing and referral to a physician
  should only occur if symptoms are found to be
  non-mechanical. Medication, radiographs, and
  referral to a specialist are still common
  protocols and must be used with more caution.
  Instead of initially seeing a physician,
  musculoskeletal pain should FIRST be screened and
  treated by musculoskeletal specialists, who are
  trained to differentiate mechanical from
  non-mechanical symptoms.

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