Back care has become an important medical issue in the United States after a number of high profile celebrity deaths. Back problems are the leading cause of work related injuries and fatalities in the United States. The issue has become so prevalent that in many state, back pain settlements have been made mandatory for workers that sustain injuries at work. However, it is important to note that these back injuries are often not immediately recognized as such by the workers, leaving them susceptible to further injury and even death if no immediate action is taken. Because of this it is recommended that employers require their employees to undergo a one-day orientation session in which the employees are educated on the signs and symptoms of back pain as well as the best way to take action should they arise.
The current trend in back care is to combine instruction on pain management with instruction on daily living skills. The trend effect is that if a person is experiencing lower back pain, the person’s ability to engage in daily living tasks will be severely limited. For example, if a person has severe pain on one side of their body, but is able to perform all daily living activities on the other side of their body, their functional capacity is severely limited because the pain has rendered them immobile. If the same person were able to perform all tasks on the left side of their body but were forced to use their right hand, their functional capacity would also be limited because the ability to perceive touch is negatively affected. It is now believed that part of the successful back pain management process involves encouraging patients to engage in daily living activities while the body is undergoing treatment.
In addition, it is recommended that therapists provide instruction on daily living skills during each session with their patients. This will help to eliminate confusion between the actual pain and the inability to perform simple daily living tasks. It is also important for therapists to distinguish between real physical limitations and expectations among their clients and to appropriately adjust the amount of therapeutic instruction based on these differences among clients. In a future article, we will address some of the differences among different types of back care therapy, including exercise, physical therapy, massage, electrical stimulation, and epidural injections.