When I ask Underwood what works, he tells me: “Whatever you do for a patient at a time when their back is really bad, the chances are they’re going to be a lot better three weeks later. So we treat people and we see them getting better and we ascribe their improvement to the treatment we’ve given, but we know that natural improvement over time is always much larger than the positive effect you get from the treatment.”…
“The truth is that low back pain is a many-faceted problem, emerging from your life situation, the state of your body and the social factors surrounding you.” Rather than trying to find a doctor who can make the pain disappear, we need to be aware that to a certain degree, it is a part of life and the best approach is to keep physically active in the right way, to find a strategy to manage stress and to keep on with normal activities. Like all complicated pain, avoiding it, trying to use a substance to blot it out, investing in one person the belief that he or she can cure you: that all makes it worse.
Prevention and treatment of low back pain: evidence, challenges, and promising directions
The authors of the review in adults concluded that moderate quality evidence existed that exercise alone, or in combination with education, is effective for prevention; and poor to very-poor quality evidence existed that education alone, back belts, shoe insoles, and ergonomic programmes might not be effective.4 The preventive effect of exercise and education was large, with a pooled relative risk of 0·55 (95% CI 0·41–0·74)…
