Research indicates that applying heat or cold, taking medication and resting do little to reduce back pain. Nevertheless, people living with the condition say differently – they list these as the top three ways to reduce their symptoms.
By Nathalia Costa
Low back pain (LBP) is very common and more costly than ever. It occurs in similar proportions around the world, interferes with quality of life and is one of the most common reasons why people of working age leave the workforce. Because so many people are affected by this condition, a huge amount of research has been conducted to learn how best to treat it. Yet there is not a single treatment (or combination of treatments) that has been shown to work well. Most pain medications, for example, have little to no effect compared to placebo.
A study recently published in the Scandinavian Journal of Pain asked people with back pain what they think decreases their LBP. Results suggest that people who experienced back pain believed that their symptoms were reduced mostly by passive strategies such as the application of heat/cold (66%), medication (64.1%) and rest (60%). Participants were twice as likely to list medication and rest first, when compared to heat/cold.
Strategies such as activity/exercise (55%), seeing a health professional (39.7%) and stretching/therapeutic exercise (38.1%) were also mentioned, but usually after the passive strategies. Reducing activities that made their back worse (34.3%) and addressing psychological aspects (31.3%) were mentioned even less often. These findings suggest that people with back pain emphasize passive treatments and consider psychosocial aspects of health to be less significant – or perhaps instead they prioritize passive treatments before trying others.
According to the Australian researchers behind the study, what individuals’ think reduces their symptoms does not match the current literature. Passive strategies such as medication and rest are not supported by research, while consideration of psychosocial aspects of health have been encouraged.
It might be easy to jump to the conclusion that these contrasts mean individuals with back pain are wrong about what affects their condition. However, another possible reason is that what people with back pain and researchers consider to be a meaningful outcome is different. Researchers usually consider a meaningful outcome to be the absence of pain and/or disability. People with back pain might have different perspectives and prioritize treatments for reasons other than efficacy, such as convenience or cost.
All these possibilities create room for further research to decrease the gap between what people living with the condition and researchers say.
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