Acute vs Chronic
There are two types of low back pain (LBP): acute and chronic (NIH, 2020). Acute LBP appears suddenly and subsides after a few days or weeks; it is usually caused by a sudden injury such as a fall. If pain persists for longer than 12 weeks, it is considered chronic (Nava, 2022).
Since 1990, the prevalence of LBP has increased by more than 50% (Wang et al., 2022). Today, LBP has become “the leading cause of disability” placing an enormous physical and financial burden on those affected (Wu et al., 2017). This makes learning about LBP causes and the most effective treatment options of utmost importance.
Causes
There are several possible causes of LBP such as injury, age-related degeneration, disease, and musculoskeletal deformities (Peloza, 2017).
Injury-related LBP may be caused by:
- Herniated disc – bulging of the spinal disc
- Muscle/tendon strain
- Muscle spasms
- Other causes of LBP
- Arthritis
- Scoliosis – spine curvature
- Degenerative disk disease – natural wear and tear of the spinal disc
Treatment
Commonly, LBP is treated using analgesic medications such as ibuprofen and naproxen. However, recent studies have shown that acute LBP is better remediated using a course of physical therapy treatment (Kim et al., 2021). Furthermore, one study showed people suffering from chronic LBP recovered with osteopathic manipulation treatment solely (Licciardone et al., 2016).
The research
Acute lower back pain
A recent study published in the journal of physical therapy compared the effectiveness of two courses of treatment for acute LBP: medication and physical therapy (Kim et al., 2021). The study included 101 participants who visited the emergency department for acute LBP. The emergency department physician assigned participants to one of two treatments:
- Physical therapy
- Analgesic medication
Over the course of three months, researchers observed patient outcomes. They found that patients undergoing physical therapy reported a greater decrease in pain levels and were less likely to need medications.
These findings were supported by a previous study by Fritz et al., 2018 which showed that if patients suffering from LBP initially received physical therapy, they were less likely to use opioids both short and long-term to mitigate pain.
Chronic lower back pain
Another study published in the Journal of Osteopathic Medicine (Online) investigated the efficacy of osteopathic manipulation in the treatment of chronic LBP (Licciardone et al., 2016).
The study included 435 participants suffering from chronic LBP. Participants were randomly assigned to one of two treatment groups:
- Osteopathic manipulation
- Sham osteopathic manipulation
Participants and researchers were not made aware of who was in which treatment group. Participants underwent 6 osteopathic manipulation treatments over the course of 8 weeks.
The researchers found that up to 25% of participants recovered from chronic LBP. Furthermore, the researchers highlighted the high safety level of osteopathic manipulation treatment.
Overall
The results of these studies suggest that physical therapy and osteopathic manipulation are safe and effective treatment options for acute and chronic LBP, respectively.
References
Fritz, King, J. B., & McAdams-Marx, C. (2018). Associations Between Early Care Decisions and the Risk for Long-term Opioid Use for Patients With Low Back Pain With a New Physician Consultation and Initiation of Opioid Therapy. The Clinical Journal of Pain, 34(6), 552–558. https://doi.org/10.1097/AJP.0000000000000571
Kim, Ciolino, J. D., Lancki, N., Strickland, K. J., Pinto, D., Stankiewicz, C., Courtney, D. M., Lambert, B. L., & McCarthy, D. M. (2021). A Prospective Observational Study of Emergency Department–Initiated Physical Therapy for Acute Low Back Pain. Physical Therapy, 101(3), 1–. https://doi.org/10.1093/ptj/pzaa219
Licciardone, Gatchel, R. J., & Aryal, S. (2016). Recovery From Chronic Low Back Pain After Osteopathic Manipulative Treatment: A Randomized Controlled Trial. Journal of Osteopathic Medicine (Online), 116(3), 144–155. https://doi.org/10.7556/jaoa.2016.031
Nava, A. M. (2022, June 9). 7 ways to treat chronic back pain without surgery. Johns Hopkins Medicine. Retrieved September 9, 2022, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/back-pain/7-ways-to-treat-chronic-back-pain-without-surgery
NIH. National Institute of Neurological Disorders and Stroke. (2020). Low back pain fact sheet. U.S. Department of Health and Human Services. Retrieved September 13, 2022, from https://www.ninds.nih.gov/low-back-pain-fact-sheet
Peloza, J. (2017). Causes of lower back pain. Spine. Retrieved September 13, 2022, from https://www.spine-health.com/conditions/lower-back-pain/causes-lower-back-pain
Wu, A., March, L., Zheng, X., Huang, J., Wang, X., Zhao, J., Blyth, F. M., Smith, E., Buchbinder, R., & Hoy, D. (2020). Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. Annals of translational medicine, 8(6), 299. https://doi.org/10.21037/atm.2020.02.175
Wang, Ye, H., Li, Z., Lu, C., Ye, J., Liao, M., & Chen, X. (2022). Epidemiological trends of low back pain at the global, regional, and national levels. European Spine Journal, 31(4), 953–962. https://doi.org/10.1007/s00586-022-07133-x
