Three Simple Strategies To Decrease Back Pain: The $29.99 Solution

The numbers are a little staggering. Eighty percent of the population will eventually suffer from non-specific low back pain. Most of those people will have back pain that presents with no apparent mechanism of injury.

The reality of most clinical practice guidelines for the treatment of low back pain is pretty simple – don’t do the things that aggravate it, do the things that make it feel better, stay active, and do not take any more than a couple of days of bed rest (if any). Though that doesn’t appear to be any sort of rocket science, the majority of the research on low back pain leads us to these simple conclusions.

Wouldn’t it be great if there was a solution that would be successful with a large number of people, provide consistent results, and focus on self care strategies? Better yet, let’s make that solution cost-effective as well, if at all possible.

How does a $29.99 solution sound to you?

With this in mind, let’s look at three simple strategies and principles that can be used on a daily basis to decrease low back pain.

1. Limit the amount of early morning lumbar flexion.

Simply limiting how much forward bending you do when you get up in the morning can have a tremendous effect on chronic, non-specific low back pain. In a 1998 study by Snook et al [1], pain days were decreased by 23%, with pain intensity reduced from 18 to 29% when it did occur. A follow-up study was completed in 2002 by Snook et al [2]. At 3 years after the initial 1998 study, there was a further 51% decrease in number of pain days.

It would appear that a simple awareness of posture and activity on arising can have great implications on non-specific low back pain. I would suggest that a few Post-It note reminders placed in conspicuous areas (i.e kitchen, bedroom, and bathroom) can certainly assist the awareness process.

Cost of increased awareness? $0

Cost of reminder notes? $2.00

2. Be aware of your sitting posture.

Simply changing your sitting posture can have an effect on back pain. In a study dating back to 1991, Williams et al [3] reported that back (and associated leg pain) was significantly reduced by sitting with a lordotic posture. What this means is that when subjects sat with the support of a lumbar roll, they had reduced back pain. Though a lumbar support isn’t a necessity to maintain that lumbar lordosis, it does make it much easier.

Cost of a lumbar roll: $16.70

3. Educate yourself regarding back pain.

Udermann et al [4] completed a study in 2004 that provided evidence that patient education alone could prove effective in the treatment of low back pain. Participants were provided a copy of “Treat Your Own Back” by Robin McKenzie. Patients had back pain for, on average, 10.4 years. One week after participants finished reading the book, 51.62% reported noticeable improvement in their pain. At 9-month follow-up, participants continued to report improvements in pain, fewer pain episodes, and an overall perceived benefit. These gains were either maintained or improved at 18-month follow-up, suggesting that both symptoms and behaviors had been affected with this educational strategy.

Cost of “Treat Your Own Back” book: $10.00

There you have it – three simple strategies to decrease back pain, and all without any expensive or prolonged treatment protocols or imaging. To summarize:

- limit the amount of early morning lumbar flexion: $2

- be aware of your sitting posture (use of a lumbar roll): $16.70

- educate yourself regarding back pain (copy of “Treat Your Own Back”): $10.00

- total cost: $28.70

- having fewer episodes of back pain: priceless.

The cost savings inherent to this type of solution, extrapolated over the 80% of the 300 million US residents that present with low back pain, is beyond staggering. Self care strategies should be the first line of care – not the afterthought that they become when patients are frustrated by the current medical system.

[1] Snook SH, Webster BS, McGorry RW, Fogleman MT, McCann KB. The reduction of chronic nonspecific low back pain through the control of early morning lumbar flexion. A randomized controlled trial. Spine 23(23), 1998.

[2] Snook SH, Webster BS, McGorry RW. The reduction of chronic, nonspecific low back pain through the control of early morning lumbar flexion: 3-year follow-up. J Occup Rehabil 12(1), 2002.

[3] Williams MM, Hawley JA, McKenzie RA, van Wijmen PM. A comparison of the effects of two sitting postures on back and referred pain. Spine 16(10), 1991.

[4] Udermann BE, Spratt KF, Donelson RG, Mayer J, Graves JE, Tillotson J. Can a patient educational book change behavior and reduce pain in chronic low back pain patients? Spine 4(4), 2004.