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Unraveling the Complexity of Low Back Pain

Low Back Pain

Viewpoint from the Journal of Orthopedic and Sports Physical Therapy

The “Viewpoint” section in the November 2016 JOSPT written by O’Sullivan, et al, offers an overview of the current research on treatment for low back pain. The authors begin by pointing out that “exponential increases in magnetic resonance imaging (MRI) scanning to identify these damaged structures have led to escalating rates of spinal fusion and disc replacements”. Surgery, along with spinal injections and pharmacological management, have limited long-term efficacy and carry significant risks.

The Physical Therapy profession has come up with a wide variety of manual techniques, taping, and exercise to help offer pain reduction and increased function to patients dealing with low back pain. The manual techniques are utilized to correct positional faults, decrease tone and guarding of the muscles, or improve flexibility. These have had good short term effects but there is limited research on the long term effects. Taping, dry needling, and electrotherapy are also shown to have short term effects. Exercise has long been touted as the best long term cure for low back pain but research does not support WHICH form of exercise works for low back pain.

So, how does a patient choose between this confusing list of options? There is “growing evidence that low back pain is a multidimensional disorder” which demonstrates the “need for a multidimensional clinic-reasoning approach to patient examination and management in order to identify the various and relevant underlying drivers of pain and disability for each individual”. Or, to put it more plainly, the evidence shows us that each person is unique. The causes of their low back pain and how it affects each individual is unique to that person. Each person has a desired level of activity to maintain or achieve which needs to drive decisions made about their care. Some people struggle with fear and anxiety that they will never have the life they want due to their pain. This needs to be addressed in some form during treatment. Patients need to be empowered with tools to utilize in their management of low back pain. These tools may include exercises, use of pain relievers, self-massage techniques, ergonomic changes, and modifying movement patterns. Support is required to grade an appropriate return to activity level for each person.

What is all comes down to is this – every BODY is different, unique, and special. Every BODY needs to be treated based on their history and on their future. Every BODY needs personalized care to make the most out of this life. Because every BODY CAN!


Dr. Amy Konvalin

Dr. Amy Konvalin

Struggling with pain and dysfunction can impact every part of our lives — it drains our energy, distracts us from our goals, and keeps us from the people and activities we love. As an Orthopedic Clinical Specialist, Dr. Amy Konvalin understands how frustrating those limitations can be — and she knows how to help get you back to the life you want to live! Beginning with a focused evaluation, Dr. Amy works to determine the root causes of your pain, as well as understanding how it affects the way you move through your world. Dysfunctional patterns of movement often grow worse with time and cause further damage if left untreated — so it’s important to address these issues as soon as possible. Dr. Amy knows there is no one-size-fits-all plan for success, and she partners with patients to identify their unique treatment goals and personal values. Using these goals as a guide, Amy uses her doctorate training in manual (hands-on) therapy and exercise prescription to treat patients with a wide variety of medical challenges and histories throughout the Maple Valley, Black Diamond and Covington areas. Dr. Amy is also a wife to a Boeing superstar/former C-130 navigator. While they lived in Germany, Dr. Amy was able to volunteer with the US Army to treat military personnel and civilians on base. She has two beautiful teenage ballerinas who keep her on her toes and educate her on all things ballet! Bailey, the princess pup, is her running partner and her napping partner. In the spare moments in between, Amy enjoys reading, yoga, wine with friends, Pilates, and walking on the beach.
Dr. Amy Konvalin

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