Good News Regarding Back Pain

Eugene Carragee, MD (et al), Chief of the Surgical Division at Stanford Hospital and Professor of Orthopedic Surgery at Stanford University Medical Center published the findings of a five year observational study in the Nov-Dec 2006 edition of The Spine Journal. The study involved 200 subjects who had no lifetime history of Low Back Pain (LBP) but were at high risk for new LBP episodes. At the outset of the study each subject was given a physical exam and underwent both x-ray and MRI studies. Subjects were assessed every six months for five years via a detailed phone interview and those experiencing any new severe LBP underwent new MRI studies within 6-12 weeks of the onset of their symptoms. All subsequent MRIs were then compared to those taken at the outset of the study. Carragee, et al made the following conclusions:

• Individuals who experience minor trauma (motor vehicle collision, minor fall, lifting injury, etc.) are at NO increased risk for long term problems as long as the injury is rehabbed properly

• Degenerative changes exhibited on MRI DOES NOT increase the risk for long term problems

• Individuals with a “heavy job” are likely to experience persistent, minor LBP but they ARE NOT at increased risk for significant LBP or disability, especially if they do not have high fear beliefs regarding their job duties.

• The vast majority of patients experiencing low back injury exhibit NO CHANGE on MRI

- Essential Messages

• We want to overcome pain not “get rid of it”

• DON’T avoid activity; activity IS GOOD

• LBP although inconvenient and at times very painful can be OVERCOME

• Return to work IS therapy

            ~ You don’t get better in order to go back to work. You go back to work in order to get better!

            ~ Some pain upon returning to activity IS NORMAL