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A cartoon picture of Specialist Physio Chris Heywood, as the author of this artical

Will My Low Back Pain Get Better?

Written by Chris Heywood - MSc BSc (Hons) MCSP HCPC reg
Physiotherapist

During our lifetime most of us will experience some form of lower back or neck pain. Research estimates that this can be as high as 90% for low back pain (LBP), and 70% for neck pain when looking at the UK population. To put that into context, the last census showed that in mid-2020, the UK had a population of just under 67.1 million people. This equates to over 60 million people with lower back pain and around 47 million with neck pain. That’s a lot of people!

An oringinal picture by Chris Heywood, physiotherapist at Team Rehab uk ltd, depicting what the lower back region area is defined as in medicine.

It comes as no surprise then that some studies have shown that lower back pain is the most common reason that you will visit your GP if we remove both headaches and tiredness from the equation. 

In the overwhelming majority of lower back pain, in the absence of Red Flags (symptoms that in some cases can imply a more serious underlying cause), the advice is to simply keep moving within your pain limitations. Sometimes, speaking to a pharmacist about short-term, over-the-counter medications to help you do this can be helpful.

 

Simple back exercises such as those recommended by the NHS  https://www.nhs.uk/conditions/back-pain/, can keep you moving as much as possible during your recovery. They are very generic however, so stop them, and get professional advice, if they aggravate your own symptoms.

The lower back is commonly defined as the area between the bottom of the rib cage and the buttock creases.

Thankfully, in the vast majority of cases, most ‘simple’ LBP is considered to be self-limiting, normally settling within 4-12 weeks under its own steam. 

 

Where pain is not controlled, or perhaps you are worried about your symptoms, it is advisable to speak to your local GP practice or specialist physio. Many surgeries now have First Contact Practitioners (FCP), some of whom may be musculoskeletal specialists (some of our specialist physios are also FCP practitioners), and they will be able to advise you on further self-help, exercises and triage you to see if further investigations are needed (if you can get through on the phone..........). As of April 2024 the funding for these NHS services and the regulations around them have all changes again so what you see in at GP surgery may not mirror what we write (written April, 2024).

 

What if My Low back Pain Does Not Get Better in 12 weeks?

First of all, don't panic. Most of the time you will still make a full recovery, sometimes aided with the correct guidance based on a specialist undertaking a proper assessment of your presentation. If you feel you have not had this then this is where Team Rehab uk really do come in to their own.

 

It would be highly inappropriate however to claim that we have a golden a bullet for everyone. Somewhere between 3-10% of people, or up to 6.7 million, who may go on to develop chronic low back pain, (the same pain lasting for more than 3 months consecutively). Although this group is proportionally small, it accounts for nearly 50% of all resources allocated to the treatment of LBP. The bottom line is, it is impossible to stop everyone from developing chronic LBP even in today’s age of medicine. What we can do however is strive to limit this occurrence where possible, and help those of you where it is not preventable, to still reach your full potential and continue to lead normal rewarding lives.

An oringinal cartoon by Chris Heywood, physiotherapist at Team Rehab uk ltd, showing a workman suffering with low back pain

.....despite what you may be told! 

There is NO RELIABLE evidence to support monthly top up's once you
are better...

Team Rehab uk is vehemently against over treatment for chronic conditions and we are big supporters of ongoing self-management strategies, such as prescribed physio exercises, Pilates, yoga etc etc, everyone is their own individual.  Such is the underlying nature of the condition we are still unable to tell you exactly what exercise is best in general, just that doing exercise is better than not doing it!

 

What you should not be doing, unless every single avenue has been exhausted, is becoming reliant upon clinical practitioners undertaking passive treatments on a regular basis. What we mean by passive is something you are reliant on the clinician for such as bony mobilisation, massage, fascial release, acupuncture. Although fantastic for their pension, it may not always be your best option.

It is also worth mentioning the ‘bio-psychosocial ‘ model that is supported and encouraged by most of the health organisations in the developed world. This recognises the importance of addressing any psychological and environmental aspects of your presentation as well as the physical. This DOES NOT mean that we think your pain is in your head, but simply that most of us will adopt behaviours and thoughts towards everyday tasks in response to our pain. This may range from something as simple as not sitting for too long in the evening to making a lengthy plan on how you will be able to get dressed in the morning. Ensuring these are only a short term adaptation, and not a long term habit that could in fact limit you reaching your full recovery potential, can be essential.

 

All lower back pain should be treated with an approach that should involve the patient in the leading role. Whether it is simple self-management, professional rehabilitation or even surgery, you will need to be prepared to adopt a temporary (majority) or permanent (minimal) change in your lifestyle to reach your full potential.  
 

Assessing and treating lower back pain across Northamptonshire and South Leicestershire is a challenge that we have significant experience in at Team Rehab uk Ltd. There are very few clinics in either area that have had the same exposure to spinal research (Chris Heywood), surgical rehabilitation and preventive care as our own. Regardless of whether you require a very first assessment, or a second opinion, we are very confident that we can provide both the honesty, integrity and quality that you deserve.

If you feel our information is helpful, please feel free to share it with others but do not take ownership in anyway

Reference List
​[i] Waddell W. A new clinical model for the treatment of low back pain.  Spine  1987; 12(7): 632-44
[ii] Kelsey JJ. Epidemiology of musculoskeletal disorders. New York: Oxford University Press, 1982 
[iii] Biering-Sorensen F. A prospective study of low back pain in a general population: 1. Occurrence, recurrence, and etiology.  Scand J Rehab Med  1983; 15: 71-9
[iv] Borenstein DG. Epidemiology, etiology, diagnostic evaluation, and treatment of low back pain  Cur Opin Rheum  2001; 13: 128-34 
[v] Clinical Standards Advisory Group. Back pain: Report of a CSAG committee on back pain  HMSO, 1994 
[vi] Maniadakis N, Gray A. The economic burden of back pain in the UK.  Pain  2000; 84: 95-103 
[vii] Nachemson AL. The natural course of low back pain. In: White AA, Gordon SL. Eds. Symptoms of idiopathic low back pain. St Louis: Mo, Mosley, 1982; 46-52 
[viii] Thomas E, Silman AJ, Croft PR, Papageorgiou AC, Jayson MI, Macfarlane GJ. Predicting who develops chronic low back pain in primary care: A prospective study. Brit Med J  1999; 19: 1662-7 
[ix] Watson PJ. Psychosocial Assessment; The emergence of a new fashion, or a new tool in physiotherapy for muscular pain.  Physiotherapy  1999; 85(10): 530-5 
[x] A systematic review of conservative treatments for acute neck pain not due to Whiplash. Howard T. Vernon, DC, PhD,a B. Kim Humphreys, DC, PhD,b and Carol A. Hagino, MBA Journal of Manipulative and Physiological Therapeutics Treatment of Acute Neck Pain July/August 2005 
[xi] Pengel LHM, Herbert RD, Maher CG, et al. Acute low back pain: Systematic review of its prognosis. BMJ  2003; 327: 323-5 
[xii] Reid S, Haugh LD, Hazard RG, et al. Occupational low back pain: Recovery curves and factors associated with disability. J Occ Rehab  1997; 7: -14 
[xiii] Nachemson A, Jonsson E. Neck and back pain: The scientific evidence of causes, diagnosis and treatment. Philadelphia: PA, Lippincott Williams & Wilkins, 2000; 495

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