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#GetPT1st For Back Pain

Chances are, you or someone you know has had back pain. Each year 15% of the population
has their first episode of back pain, and over the course of our lives, 80% of us will have back
pain. Even though back pain is common, the medical community does a poor job managing it.
Stories of chronic pain, opioid use, multiple surgeries, and a lifetime of disability are far too
common.

Let’s look at some of the common treatments for low back pain and see how they stack up against physical therapy:

Medication

Low back pain is the #1 reason for opioid prescription in the US, however in 2106, the CDC
recommended against the use of opioids for back pain in favor of “non-drug treatments like
physical therapy.”

Imaging

Having an X-ray or MRI for back pain is common, however it’s rarely needed or helpful.
Research has NEVER demonstrated a link between imaging and symptoms. As we age, degenerative changes on imaging is common.
● 90% of people age 50 to 55 have disc degeneration when imaged, whether they have symptoms or not
● In 2015 a study that looked at 1,211 MRI scans of people with no pain found that 87.6% had a disc bulge
● Just getting an image increases the chances that you’ll have surgery by 34%

Surgery

The US has sky high rates for back surgeries – 40% higher than any other country and 5x higher
than the UK. You’d think that with all the back surgeries we do, we’d be pretty good at it but the
outcomes are terrible!
A worker’s comp study looked at 725 people who had spinal fusions VS 725 people who didn’t.
The surgical group had:
● A 1 in 4 chance of a repeat surgery
● A 1 in 3 chance of a major complication
● A 1 in 3 chance of never returning to work again

Physical Therapy
● Current clinical practice guidelines support manual therapy and exercise
● Research proves that early PT lead to better outcomes with lower costs, and decreases
the risk of surgery, unnecessary imaging, and use of opioids
● A study of 122,723 people with low back pain who started PT within 14 days found that it
decreased the cost to treat back pain by 60%
● Unfortunately only 2% of people with back pain start with PT, and only 7% get to PT
within 90 days.

Despite the data showing that PT is the most effective, safest, and lowest cost option to treat low back pain, most people take far too long to get there. Almost every state has direct access, meaning that you can go directly to a physical therapist without a doctor’s referral. If you see your doctor for back pain, and PT isn’t one of the first treatment options, ask for it!

Life is a Movement Journey, Here’s How PT Can Help

Now that spring has arrived, temperatures are starting to rise in many parts of the country. And
that means the transition from heating our homes to cooling our homes is right around the
corner. No matter what method you use to cool your home during the warm spring and summer
months (central air conditioning, window units, or fans and dehumidifiers), each spring you cross
your fingers that your approach still works. If not, you might be calling an expert for a tune-up,
or in extreme circumstances, you might need a complete overhaul.

Just like an AC system that has probably been dormant for many months of the year, a body
that hasn’t been physically engaged on a regular basis may have trouble getting started again.
And yet, this time of year, the warm temps draw many people to city and suburban streets,
tracks and trails, ready to take that first run of the season. A good percentage of these spring
runners haven’t kept up their strides throughout the winter. It should come as no surprise that a
4-mile run for a previously inactive person is going to stir up a few aches and pains.

Especially as we age, our ability to move undergoes changes. But whether we’re talking about a
college student or a retiree, returning to an activity without proper planning is a recipe for
disaster. That’s where physical therapy comes in. Physical therapists are trained to treat injuries
and ease pain, but they can also help their patients prevent injuries and safely prepare to
participate in new activities.

Think of physical therapists as “movement consultants” who can ensure that your body is
physically ready to tackle a new challenge—or resume a favorite leisure activity. Here’s another
example to illustrate what we’re talking about: Let’s say that you play in an adult soccer league
and you’re preparing to play in your first game of the season in a few weeks. You probably hung
up your cleats when the last season ended months ago, but expect to pick up just where you left
off. But it’s simply too much to ask for your 2019 debut on the field to be on the same level as
the last game of the previous season, when you likely had reached peak performance.

This is a good time for your PT to step in and help you shake off the rust. The rehab professional
can customize an exercise plan to help you slowly return to sport and avoid an injury that could
sideline you for the whole season. Or like cleaning the filters before firing up your air
conditioner for the first time this year, the rehab expert can help to ensure that your body is
prepared to return to its former activity level following a hiatus.

The Number One Thing You Can Do to Improve Your Physical Therapy Experience

Dealing with the pain and limited mobility associated with an injury or illness can be stressful for so many reasons. You might have questions like, “How long will I be sidelined?” and “What do I need to do to get better?” Or maybe you’re worried about how you’ll pick your children up from school, walk to the train for your commute or prepare meals for your family.
These are all perfectly normal concerns. Luckily, there are some ways that you can gain control over the situation and ensure that you return to the activities you care most about—especially if physical therapy is part of your plan.

What you can do before your very first appointment—and during physical therapy—to take control of that injury-related stress? First and foremost, it’s important to come prepared for physical therapy. And no, I’m not talking about dressing appropriately and arriving on time (or even better, 15 minutes ahead of your scheduled appointment). That stuff is important, of course, but there’s one thing you can do in the days leading up to your appointment that will set you up for success.

Any guesses? I’m talking about starting a list. What kind of list? Well, every time that you feel pain in the affected area or notice an activity that is harder than it was pre-injury, add it to the list! And the more specific you are, the better. Here’s an example to help drive this point home: Let’s say that you’re recovering from a moderate meniscus tear and you have an appointment with your physical therapist in three days. Take notes on how your knee feels first thing in the morning after you’ve been off your feet. How does your knee react when you stand up from a chair—does it feel unstable? Or do you find that you need to clutch the back of the couch on your way to the bathroom? Sharing each of these details helps your physical therapist understand your limitations beyond the injury printed on your intake form.

Now let’s take that list a step farther and add some details about the activities that you typically participate in on a regular basis. Let’s say that you normally play a weekly round of golf, spend your mornings weeding your garden or meet up with friends for a four-mile walk two evenings a week. These activities have become an important part of your life so let’s make sure that they’re factored into your list, perhaps in the “what you hope to get out of physical therapy” category. Painting a clear picture of how active you are—and what types of activities and sports you participate in—can help your physical therapist design an individualized treatment plan and to better help you on your road to recovery.

Have you been to physical therapy lately for an injury? Did you find anything else that helped maximize your time in rehab or that improved communication with your physical therapist?

What Brings You to Physical Therapy Today?

When you kick off a new project at work, chances are you spend a fair amount of time setting and reviewing goals. These goals help you—and those you’ll be working with—get a clear sense of what you’re looking to achieve and begin to map out a plan of attack. Along with specific goals, you also probably find it helpful to set some key milestones to ensure that you stay on task and to prevent your motivation from waning.

These same principles apply when going to physical therapy for an injury. Communicating what you hope to get out your therapy sessions can help your physical therapist to individualize the treatment plan and design an exercise program that aligns with your goals. The idea is to move from “I’m here because my knee hurts” to “I’d like my knee to feel better so I can get back to doing X, Y and Z.”

Let’s talk about a concrete example to illustrate goal setting in action: A father of three ruptures his Achilles tendon while playing a game of pickup basketball after work. When he lands in rehab, he explains to his PT that he’s due to walk his oldest daughter down the aisle at her wedding in a few months. This gives the PT a specific goal—and a timeline—to aim for. Of course, not every patient has a goal tied to such a momentous occasion. It can be as simple as carrying your groceries to your car unassisted or lifting your grandchild into a highchair. Either way, it’s important to have goals—and to communicate them clearly to your physical therapist.

Your PT wants you to get better but without the right guidance from you, he might default to following a checklist and design a program that unknowingly misses your goals. Only you know precisely what you want out of PT: If you have a wrist injury and getting back to your knitting hobby is important to you, then be specific! Another patient could come in with the same injury but have completely different goals, so guide your PT to help you achieve what’s most important.
Proper communication ensures success, and that means you can’t passively participate in your care and simply listen to what the PT recommends. Instead, communication needs to be a two-way street. So next time you’re at physical therapy, speak up: Make sure that your PT knows precisely why you’ve made the appointment, what you hope to get out of it and why it’s important to you. This information not only helps your PT make important decisions about your care but also to think of new ways to keep you motivated during therapy.

If you find yourself making an appointment to see a physical therapist for a new injury or a nagging pain, make sure that you prepare in advance. Being prepared to answer this one simple question can help to ensure that rehab is a success: What brings you to physical therapy today? After all, you wouldn’t walk into a kickoff meeting at work without first giving some thought to the goals that you planned to share with your team, would you?