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Why Is Early Treatment for Acute Low Back Pain So Important?

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Updated November 09, 2009

Question: Why Is Early Treatment for Acute Low Back Pain So Important?
Answer: If you’re not careful, an acute back or neck injury may lead to a disability. There are two different ways this could happen. First, if you don’t control inflammation and subsequent potential scar tissue development, the result may be decreased flexibility (called range of motion), pain, muscle spasm and trigger points. Begun early, anti-inflammatory pain medication and physical therapy are the treatments of choice for preventing a transition from acute pain into chronic back pain.

The second way an acute back problem can become chronic and disabling is from permanent changes in your nervous system that may amplify and distort sensations. The nervous system will begin to interpret all sensations as the type that cause pain. As a result, pain is exactly what you will feel -- even if you are only experiencing a simple pat on the back or a shift in your sitting position.

Another way to understand this: Without early treatment, the nervous system may stop distinguishing between different signals that create feelings of touch, pressure, temperature, or body position -- and instead substitute them all with pain.

The chronic nature of your back problem may subject you to a number of different types of distorted responses to pain including:

Early treatment can prevent the (permanent) changes in the way your nervous system processes pain and other felt sensations.

If you are still hesitant to receive treatment, you’re not alone. People with acute back pain often give into fears of re-injury by avoiding movement, exercise and daily activities, called fear-avoidance behavior. But skipping your therapy or treating the problem with bed rest puts you at risk for developing a chronic back problem. While doctors and spine experts recommend remaining active when you have acute back pain, they also suggest modifying the things you do to avoid worsening the pain.

Lastly, researchers have found that personality, attitude and social conditions play a big role in determining how long the pain will last, and how severe it gets.

Sources:

Calliet, R. Low Back Pain Syndrome. 5th ed. Pain Series. F.A. Davis. Philadelphia.

Fritz, JM, George, SZ, Delitto, A. The role of fear-avoidance in acute low back pain: relationships with current and future disability and work status. Pain. Oct. 2001.

Valat, JP, Goupille, P, Vedere, V. Low back pain: risk factors for chronicity. Rev. Rhum Engl. Ed. Mar, 1997.
Grotle, M., Vollestad, NK, Vejerod, MB, Brox, JI. Fer-avoidance beliefs and distress in relation to disability in acute and chronic low back pain. Pain. Dec 2004.

Wand, BM, O’Connell, NE. Chronic non-specific low back pain – sub-groups or a single mechanism? BMC Musculoskeletal Disorders. Jan. 2008.

Gould, Harry, III, MD, PhD. Understanding Pain: What It Is, Why It Happens, and How It’s Managed. Demos Medical Pub. Dec. 2006.

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