Back Pain? Get to a Physiotherapist Immediately!

Raj Suppiah, MScPT, BHScHons.

What do you do when you get back pain? Do you wait it out? Sit for hours at a walk in clinic? Wait a few days, then see your family doctor? Take pain medications?

The above scenarios are typical reactions when someone experiences back pain.  However, a recent study published in the journal SPINE (Fritz et. Al, 2012) revealed that the sooner you start physiotherapy, the less time you will spend with back pain AND the lower the cost for both yourself and the health care system.

A typical timeline looks like the following:

Back Pain > wait it out (1 week) > no change > book an appointment with your doctor (2-3 days) > get an x-ray (2-3 days) > x-ray does not reveal anything significant & doctor prescribes medication (2-3 weeks) > still no real changes, doctor refers to physio (2-3 days) = 3-5 weeks.

In the above scenario, it may take over a month before seeing a physiotherapist . The result is wasted health care dollars in physician visits, medications and imaging. More importantly, it has wasted your time and likely resulted in time  off work and decreased participation in your active lifestyle due to pain.

Delaying a trip to the physio office can allow symptoms to develop into a chronic problem.  Your body will begin to compensate for the back pain, potentially causing secondary issues. In the case that medication does “work”, it is usually masking the symptoms, and not addressing the underlying CAUSE of your back pain.

People often ask if they need an x-ray before starting physiotherapy.  The short answer is no. Despite what is revealed on an x-ray, a physiotherapist can assess and intervene properly. Only in very rare circumstances, such as a fracture, would a physiotherapist need to intervene differently. Fractures of the spine are extremely uncommon, and usually occur through severe trauma.

Here’s a better scenario:

Back Pain > book an appointment with your doctor (2-3 days) > doctor refers medication AND physiotherapy (2-3 days) = 1 week

This scenario takes about one week before seeing a physiotherapist.  If your physician has not referred to you a physiotherapist, don’t be afraid to ask.

Here’s the best case scenario:

In Ontario, you can access a physio directly without having seen a doctor. Physiotherapists are primary health care practitioners, which means we can assess, diagnose and treat independently. Most physio clinics should be able to get you in for an assessment within a few days.

Without downplaying the importance of our physician friends, visiting a physiotherapist directly when back pain begins is a more efficient use of your time. A physio conducts a detailed and specified physical assessment so he/she can understand the true cause of your pain and therefore, intervene properly.   Most of the time, back pain is resolved through manual therapy techniques, movement exercises and core strengthening, areas of expertise your physiotherapist can provide you.

With the right physiotherapy intervention, symptoms of back pain can be often be resolved within two weeks. Your physio can also show you how to prevent future episodes through postural and strengthening exercises. As the research suggests, the longer you wait, both the cost and the time to full recovery increase.

So the next time you or someone you know experiences low back pain, don’t wait; visit your physiotherapist immediately!

Raj is co-owner and physiotherapist at Foundation Physiotherapy. He is currently credentialing through the McKenzie method, a recognized program worldwide in assessing and treating low back pain.