I'm totally freaked out. My whole family has chronic back pain. Up until now, I've been the only one without it -- and I want to keep it that way. But last night, I was shoveling snow and felt my back go out on me. Am I doomed to be like the rest of my family members who can't do anything fun because their backs always hurt (or might hurt)?
There's a commonly held belief that once you've had an episode of low back pain (LBP), you are liable to have another. Studies estimate that the recurrence rate for LBP can be as high as 84 per cent. But the authors of a new study challenge that thinking. They point out how research in this area has been flawed.
There are three common errors in research that have led to an over estimate of LBP recurrence. First, patients included in the studies may not have recovered from the first episode of back pain before they had a second episode. Technically, they have not had a recurrence but rather, persistence of symptoms from the first episode.
Second, some patients recover from their first episode of back pain but not right away. Their recovery may take months instead of days or weeks. Recovery so late means they were at risk of recurrence for a very short amount of time. Using that approach results in misleading numbers of patients reported to have a recurrence of low back pain.
Third, the definition of an episode of back pain isn't always the same from one study to the next. This may be changing with some of the more recent studies as authors have become aware of the problem and are making efforts to use a more standardized definition.
The current definition proposed for future studies is as follows. An episode of low back pain is a period of pain in the lower back lasting for more than 24 hours. It is preceded by and followed by a period of at lease one month without low back pain.
Using that definition, you can gauge your own recovery. A fear of pain lingering on is a risk factor for exactly that! The more people fear an event happening (such as repeat low back pain), the more likely it is that they will indeed develop ongoing or chronic pain. Some of this occurs because the individual stops moving or becomes much more inactive out of fear that they might hurt themselves again.
A previous episode of back pain does put you at risk of a second episode, but this happens far less often than anyone believes. Instead of the nearly 90 per cent rate of recurrence reported, it's likely to be more like 25 per cent. That translates to one in four people.
Don't be a statistic. The best thing you can do for yourself is to keep moving. Stay active. Don't avoid movements or activities because it might hurt or you might hurt yourself. This type of thinking is called fear avoidance behavior. Thinking this way can also increase your chances for further problems that you obviously don't want.