No 'magic key' to elusive back pain

The specific cause of back pain is sometimes elusive. But whether you know the cause or not, relief — and prevention of future injuries — is possible.

"There's some research suggesting only 10 to 15 percent of people who seek help for back pain get a true diagnosis," says Aaron Swalberg, a physical therapist at The Orthopedic Specialty Hospital who has a master's degree as well as orthopedic certification. "It's mostly a general diagnosis of back pain or lumbago — terms that don't mean a whole lot in individual cases."

Some studies estimate 15 percent to 20 percent of the adult population will experience back pain in any year. Of those, about 90 percent get better and have no problems within six months. But more than half — as high as 70 percent — will experience a recurrence.

Back pain is the topic of today's Deseret Morning News/Intermountain Health Care Hotline. From 10 a.m. to noon, Swalberg and fellow TOSH physical therapist Barry Olsen will take phoned-in questions.

One problem with diagnosis, Swalberg says, is the difference between people. Put 100 people in a magnetic resonance imaging machine and "for a good number" of people with no back pain, there'd be "significant findings." Conversely, nothing may be visible on the MRI of someone who does complain of pain.

Increasingly, Swalberg said, patients are being categorized in groups based on their symptoms, rather than by the actual anatomical problem that's occurring. By doing that, care providers find they can more effectively treat people who suffer back pain, using techniques such as manipulation or mobilization.

Not all back pain is even in the back. Swalberg says leg pain may trace to a back problem. And how pain presents makes a big difference in therapy. Is it just in the back? In the back and leg? Perhaps it's just in the leg.

One of the first things physical therapists do is determine how much a patient can move without significant pain and then use and expand that.

"We have basic stretches we give people on a regular basis that can be beneficial, but there's no magic key. I wish there were," Swalberg says.

Comfortable positions help, too, such as lying on your back with your feet on a chair at a 90-degree angle or lying on your side with knees bent. Just don't stay down too long, Olsen says.