The Current

Chronic back pain? Journalist investigates what works and what doesn't

Back pain affects most Canadians. Investigative journalist and back pain sufferer Cathryn Jakobson Ramin says it's time to rethink treatment.
Author of Crooked and investigative journalist Cathryn Jakobson Ramin says how we commonly treat back pain most often doesn't work. (Howard Schatz/

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Got back pain? You're not alone. Four out of five adult Canadians will experience at least one episode of lower back pain.

Investigative journalist Cathryn Jakobson Ramin suffered from back pain for years and decided to look into the world of back pain treatments.

Most people who are in chronic pain ... are often unable to work ... They're desperate.- Cathryn Jakobson Ramin

The author of Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery says there's little evidence that conventional back pain treatments — chiropractic care, surgery, spinal injections — work, or at best have only marginal benefits. 

But she says people keep pursuing these treatments because they want relief so badly. 

"When you're in pain, you're in no position to ask a lot of questions. Most people who are in chronic pain are having a lot of problems. They are often unable to work, they have issues at home ... They're desperate," Jakobson Ramin tells The Current's Anna Maria Tremonti. 
Most adult Canadians will experience at least one episode of lower back pain. (CBC)

Jakobson Ramin says she tried everything — chiropractic care, yoga, pilates, physiotherapy — and then eventually turned to surgery which didn't help. 

"There's very little evidence that shows surgery is more successful than intensive rehabilitation ... you might as well skip the surgery and go straight to the rehab."

Along with trying to copy with the chronic back pain comes the emotional fallout.

"People feel extremely lonely and frustrated and angry," she tells Tremonti.

"Isolation is a major factor in making things worse because when you can no longer feel like it's safe to go out, you start to really sit there and obsess about your pain and your situation."

How to get back pain relief

Jakobson Ramin says there's hope for back pain sufferers, but it takes a radical mindset shift.

According to evidence, she suggests the best approach is the exact opposite of the advice most people receive, which is generally to rest, to lie on the floor, to avoid lifting. 

"What often goes unsaid is that in nearly every case it is perfectly safe and advisable to continue to live the lives they were living and that is in fact how they will get better," Jakobson Ramin explains.

"If there's a message I'd like to convey is that for the gross majority of patients, hurt does not mean harm. And when you stop moving, when you take to the sofa, when you let your muscles become deconditioned, when you gain 40 pounds, when you become addicted to opioids, this path is going in the wrong direction."

What works is exercise and rehab, Jakobson Ramin says, and if people want to overcome their back pain, expect it to take a long time.

"People are looking for someone to solve their problems. Someone who can fix them. You cannot expect to get on a table, any kind of table, and have the problem resolved by someone else. It's going to take hard work on your part."

Stuart McGill treats people with chronic back pain and shares key exercises for people with bad backs.

VIDEO: University of Waterloo's Stuart McGill demonstrates core exercises [NYT]

Listen to the full conversation at the top of this web post.

This segment was produced by The Current's Willow Smith.