There may be many different treatment approaches to acute back pain - however there is only one approach that successfully overcomes chronic long term back pain.
The causes for acute back pain (pain less than three months) are usually joint or muscle related.
Muscular spasm or a restriction of the lumbar facet joints can be very painful and often feel a lot worse the the condition really is. There are many effective techniques employed by a range of different practitioners such as joint mobilisation in physiotherapy, spinal adjustments in chiropractic care or deep tissue release in myotherapy based therapies. All of these techniques are aimed at releasing tension present in the afflicted muscles and joints of the lower back.
The difference between acute back pain and chronic back pain is much more than just the length of time one has suffered with the condition. Ie < 3 months is deemed to be acute back pain whilst > than 3 months is deemed to be chronic. As we have already covered, in most cases acute pain only involves tight and or restricted joints and muscles of the back, whereas the is only one factor (often times purely the symptom) in chronic back pain cases.
In chronic back pain, at lot of changes occur in the lead up to first experiencing pain. Postural imbalances set in resulting in a lack of support for the back. This lack of support overloads the muscles, joints and intervertebral discs of the lower back which results in pain, injury and or pathology to present in the region. At this point the back typically goes into acute spasm, resulting in a 1-3 week on average (note this can last longer) period of minimal movement as the body attempts to recover from the injury. This period of inactivity further weakens the postural muscles integral to the support of the lower back.
The chronic pain cycle begins! Lack of strength in the areas integral to the support of the back results in compensatory patterns setting in as a protective mechanism against further damage to the back. This further reinforces the postural imbalance, the muscles of the posterior chain (erector spinae, gluteals, hamstrings and adductors) weaken and atrophy, whilst the anterior muscles (deep internal/ external rotators of the hip, hip flexors, iliopsoas and quadriceps) compensate by taking much of the load in compensation for the weakened posterior muscle group.
Acute back pain typically only involves tight and restricted muscles and joints - symptoms
Chronic back pain, always involves both tight and restricted muscles and joints - symptoms as well as weakened postural muscles, and compensatory movement patterns - underlying cause.
In almost all cases where people present to our clinic frustrated at the lack of lasting results they are getting for their chronic back pain we see a history of treatment that has focused on the symptoms (techniques employed to eradicate tension and restricted) whilst completely neglecting the true underlying cause which is what brought on the back pain in the first place.
This approach results in short term temporary relief from chronic back pain, the tension and restriction is released, the patient feels better for a short period of time only for the pain to return because the back is overloaded and compromised due to the lack of support and postural symmetry integral to a healthy back.
So the solution to chronic back pain is a two step approach that address both the symptoms and the true underlying cause (both the tension/ restriction and the weakness/ compensatory movement patterns).
Combine the two approaches and you get a highly predictable outcome for the chronic back pain sufferers.
This article was written by Rick Saunders. Rick Saunders is a chronic back pain specialist based in Richmond in Melbourne Australia and has helped over 10,000 chronic back pain sufferers overcome this debilitating condition since 2001.