Low back pain is an epidemic in the world today affecting many adults at some point in their lives. From work responsibilities to our leisure activities, new or recurrent back pain can be harmful to all aspects of life. As a Doctor of Physical Therapy, much of my patient care is focused on improving spinal health and getting to the root of people’s pain. At Grace Physical Therapy in Summerville, we are specially trained to diagnose and treat all aspects of spinal pain. With certification through the McKenzie Institute of America in Mechanical Diagnosis and Therapy (MDT), we strive to diagnose and treat the root cause of one’s problem rather than putting a band-aid onto symptoms that may have a deeper source.
There are, however, several misconceptions that can get in the way of recovery. These ingrained beliefs can be not only discouraging to live with but can also cause you to feel like there is no way to resolve symptoms other than invasive procedures.
Misconceptions:
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I have Arthritis and Degenerative Disc Disease, so I’ll always have pain:
Quite frequently people are given diagnoses and then not educated properly regarding the best approach to deal with their diagnosis. From Arthritis to Degenerative Disc Disease (DDD), many things are found normally in the aging adult that doesn’t necessarily require pain to present. There are many avenues that will help reduce and sometimes abolish pain even in the presence of arthritis and DDD. The problem in many cases is that once someone is diagnosed with one of these normal aging processes, they fall into the false belief that nothing can be done for them, so they quit trying. Or worse, they rush too quickly to surgery which not only has high risk but also gives no guarantee to “fix” the problem.
At Grace Physical Therapy, it is always our goal to get to the root problem of what is causing the current and specific pain. This takes time and an in-depth differential process to make sure that symptoms are being resolved and the root cause of these symptoms is being addressed. This also takes high-quality care and a systematic approach which our MDT training affords us. Not all physical therapy is the same. Make sure that the therapist treating you understands the importance of full reduction, maintenance, recovery of function, and prevention. This will equip you, as the patient, to self-treat in the future.
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I must lose weight for my back to stop hurting:
I want to be very clear up front, losing a little weight (or a lot in some cases) will almost always help reduce stress on skeletal structures as well as make you overall healthier. From diabetes to cholesterol, there are countless benefits from living a healthier lifestyle, and in most cases that will lead to weight reduction and reduced stress. The low back, however, is a very resilient and inherently stable group of structures. It has an uncanny ability to adapt to slow changes in body size and activity.
The majority of low back pain comes from some sort of mechanical problem at the level of the disc and joint. Mechanical problems are simply defined as structures that are not currently moving as they should be. This can happen from repetitive stresses such as frequent sitting, improper bending/lifting, or other leisure or household activities. The good news about a mechanical problem is that there is likely a way that you can move the back that will fix the mechanics of the spine. We call this specific motion a directional preference. Once this directional preference is figured out, we greatly increase the chances of fixing the structure that is causing the pain production. Yes, even without losing weight.
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If I strengthen my core my back will quit hurting.
Athletics has always been in my blood. For as long as I can remember, I’ve played sports. This meant spending countless hours in the gym and weight room always trying to get stronger. When I first began my Physical Therapy career, I put too much emphasis on increasing core strength prior to making sure that the mechanics of the lumbar spine were assessed. Something that helped change my perspective was the countless patient athletes I began to treat that had a stronger core than you could imagine. Their core was strong and yet they had back pain just like my other patients. What was I supposed to do? Tell them that they need to strengthen their core if they want to get their pain to go away? Of course not! This led me (and many others much smarter than me) to come to the realization that mechanical problems can onset regardless of pure muscle strength.
Once I began to understand that mobility was a prerequisite for proper strengthening and mechanics, I started to put less stress initially on increasing core strength and more focus on fixing the underlying mechanical problem. This led my practice to have far more success with our strengthening programs because we have already fixed the primary source of pain. Strengthening too early can be just as detrimental to health as no strengthening at all (sometimes even more so).
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I need imaging to know what is wrong with me.
For many years, the standard of care in the healthcare community was to start the care process with imaging. Whether it is an X-ray, MRI, or CT scan, there are countless patients who still believe that this will help them “know” what is wrong with their back. They also believe that “knowing” will significantly help direct their care more appropriately. What history and research have taught us is that imaging is only an aid to help as a last resort to unchanging symptoms. Unless there has been a traumatic event, an image is an expensive test that will help direct treatment very little.
One thing that people don’t realize is the progression of the physical therapy profession to a Doctoral degree. The largest area of improvement in the education process of the Doctor of Physical Therapy is in the differential diagnosis of orthopedic conditions which includes knowing when imaging is absolutely necessary. My wife, who is a primary care Nurse Practitioner, calls me her human MRI machine. I say this not to brag about myself but about my profession. Doctors of Physical Therapy have become the Direct Access Musculo-skeletal experts second only to the Orthopedic surgeon. This should give you, the patient, confidence that we will be able to decipher the cause of your pain and initiate treatment in the safest and most effective way possible. It should also give you confidence that we will be able to direct you to any other medical professional if we are not the appropriate person for you to see.
These misconceptions are a few of the most common ones that I see in my daily practice. As a Doctor of Physical Therapy, I have the unique opportunity to walk with patients through their times of pain. At Grace Physical Therapy, it is always our goal to make our patients feel like family. We strive to treat everyone that we see with the highest standards for quality and integrity. We also specialize in spinal problems, many of which have caused significant disability for individuals young and old. We have had great success implementing the McKenzie Method into our everyday practice to help fix serious pathology and improve the functional capacity of our patients over the past 16 years. We would love to talk to you more about your pain and help you get back to a pain-free life. If you are interested in better understanding your back pain and learning if there is a way to ease your symptoms, please visit our website at www.GRACEPT.com or reach out to me directly at jlethco@grace-pt.com
440 Old Trolley Rd. Ste E
Summerville, SC 29485
Email: jlethco@grace-pt.com
Website: www.gracept.com
Tel: 843-871-3522
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