#13- The Problem With Low Back Pain

In this episode, we discuss the problem with low back pain and why physical therapy should be at the forefront for treating it. Sign up to receive our weekly newsletter. Follow us on Youtube and Instagram Please leave us a comment and a review. Please email us at [email protected] with any suggestions for future episodes or if you are interested in being a guest. Links to our favorite products and services: https://riverside.fm/homepage?utm_campaign=campaign_2&utm_medium=affiliate&utm_source=rewardful&via=d8d979 Disclaimer- Any information on diseases and treatments available at this channel is intended for general guidance only and must never be considered a substitute for advice provided by a doctor or other qualified healthcare professional. Always seek the advice of your physician or other qualified healthcare professional with questions you may have regarding your medical condition. Time stamps 0:00:00- Intro 0:01:10- common misconceptions about back pain, limitations of an MD visit for back pain 0:05:52- the problem with imaging for back pain and direct access laws (it is possible to see a PT before seeing an MD) 0:19:50- reversing the pyramid of back pain treatment to a PT centered model, seeing imaging as “static snapshots in time” 0:22:30- who should actually go for imaging 0:27:00- scary language and association with adverse outcomes, what the US health care system is designed for 0:30:09- studies showing that early imaging does not change outcomes and does not correlate with clinical symptoms, unnecessary referrals to surgery 0:40:00- the under-utilization of physical therapy, incidental findings on imaging (disc herniation, arthritis, spinal stenosis) 0:48:06- which medications actually work for back pain, injections, their side effects and lack of long term benefit 0:54:20- the root cause of back pain, the bio-psycho-social approach to back pain 1:00:38- Outro Studies Imaging strategies for low-back pain: systematic review and meta-analysis.Chou R, Fu R, Carrino JA, Deyo RA Lancet. 2009;373(9662):463. Association of early imaging for back pain with clinical outcomes in older adults. Jarvik JG, Gold LS, Comstock BA, Heagerty PJ, Rundell SD, Turner JA, Avins AL, Bauer Z, Bresnahan BW, Friedly JL, James K, Kessler L, Nedeljkovic SS, Nerenz DR, Shi X, Sullivan SD, Chan L, Schwalb JM, Deyo RA JAMA. 2015 Mar;313(11):1143-53. Observational Study of the Downstream Consequences of Inappropriate MRI of the Lumbar Spine.Jacobs JC, Jarvik JG, Chou R, Boothroyd D, Lo J, Nevedal A, Barnett PG J Gen Intern Med. 2020;35(12):3605. Epub 2020 Sep 28. Magnetic resonance imaging of the lumbar spine in people without back pain.Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS N Engl J Med. 1994;331(2):69. Intraspinal cross-section areas measured on myelography--computed tomography. The relation to outcome in nonoperated lumbar disc herniation. Oland G, Hoff TG Spine (Phila Pa 1976). 1996;21(17):1985. Links Work by Peter O'Sullivan: https://www.iasp-pain.org/publications/relief-news/article/time-to-put-away-the-magic-bullet-theory-of-back-pain-peter-osullivan-talks/