If I had an episode of lower back pain, am I always going to be more likely to have lower back pain in the future?
It is true that once you have an episode of lower back pain or shooting leg pain, you are probably more likely to have it in the future - if you do nothing. But you are not going to "do nothing."
I see a lot of patients with lower back pain and shooting leg pain. Once we work together to resolve the pain, a very common question and concern that is raised is whether the pain is likely to return. A typical example is the following: Mr. X comes in with lower back pain that shoots into the right leg all the way to the foot. MRI reveals a herniated disc at L5-S1 level. After an injection, the pain is 90% better. Next, Mr. X starts physical therapy. Six weeks later, I see Mr. X back in the office and the pain is completely disappeared. However, Mr. X is concerned that ther herniated disc is still there so, "Won't the pain just return?"
While it is true that Mr. X's herniated disc is likely to still look the same on MRI even though his symptoms have resolved, it is important to remember that many people have herniated discs on MRI but do not have lower back symptoms.
Often, once the inflammation caused by a herniated disc is treated, the symptoms go away and stay away. The bottom line is that most people will have an episode of lower back pain at some point in their life. This lower back pain episode could likely be avoided in many people if they took the time to exercise and take care of their backs. For Mr. X, the glass can be half empty or half full-it all depends on perspective.
An episode of lower back pain shooting into the leg, and a herniated disc on MRI that is consistent with Mr. X's symptoms would certainly tend to predispose him to another episode of back pain at some point in the future.
This is clearly the glass half empty perspective. However, Mr. X will not "do nothing." Instead, Mr. X will continue the 15-minute home exercise program his physical therapist taught him to continue to protect his back. If Mr. X continues this regimen as part of his normal workout routine, then in some ways he is probably less likely than other people to develop lower back pain symptoms in the future. Of course, this is the glass half full perspective.
The truth is a combination of the glass half full and half empty perspectives. The bottom line is that everyone is at risk for lower back pain symptoms and the best way for all of us to prevent them is to learn a home exercise program that is appropriate for us and make it part of our normal, workout routine.