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Get ahead of back pain

Although the aching stems from different causes, you can help control the problem.

By Dr. Tedd Mitchell

According to data from the National Institutes of Health, back pain affects a

Physical therapy can teach you the mechanics of how the back operates and how it should be supported.

whopping 80% of us at some time. Given this fact, it's important to understand what an aching back is trying to tell you. Let's begin with an explanation of pain in general. The perception of pain (the medical term is "nociception") is a tool Mother Nature uses to protect us; it's her way of slapping us on the wrist when we expose ourselves to something dangerous. Touch a hot stove, and before you realize it, you've pulled your hand away. Over time, we learn through negative reinforcement what situations are potentially dangerous (such as the approach of strange dogs or playing with matches).

Nociception, which is critical to our survival, becomes a problem when it's not working correctly -- when we are overly sensitive to pain or not sensitive enough for our own good. At one end of the spectrum is a tragic, rare condition called congenital insensitivity to pain with anhidrosis, or CIPA. People with this disorder are not capable of feeling any pain. They often injure themselves, sometimes with dire consequences, without even realizing it.

At the other end of the spectrum is heightened nociception, related to injury, overuse or illness. This is where back pain comes in. The causes of back pain vary widely: disk problems, arthritis, misalignment of vertebrae, muscle imbalances, posture and even emotional stress, to name a few. Although back pain is sometimes linked with a specific problem (sciatica caused by disk problems, for example), it's quite common for folks with very different back problems to experience similar kinds of back pain.

This can make dealing with a sore back frustrating for patients. They see the doctor, undergo an evaluation and walk away thinking, "Nothing is wrong." I often hear this from patients. However, when I get the records, I usually find that they do have a problem, although not necessarily something that requires an intervention such as surgery or injections.

I explain that it's generally good news when a doctor specializing in back problems doesn't find anything that requires invasive treatment. Most patients can alleviate their pain by focusing on strengthening the muscles that support the lower back. That kind of activity can be complicated enough that it requires a physical therapist's supervision, at least initially.

Understanding that we have some control over actions that affect the severity of our back pain can be liberating and motivating. Too often, back-pain sufferers see physical therapy as a "quick fix." But for this chronic condition, physical therapy is so much more. It takes time to learn the mechanics of how the back operates and how it should be supported. Learning that is necessary if we want to keep Mother Nature from always slapping our wrists.

Contributing Editor Tedd Mitchell, M.D., president and medical director of the renowned Cooper Clinic in Dallas, writes HealthSmart every week.