Fairview: Interview With A Back Pain Physician

Dr. David Berk, Chiropractic Sports Physician and Certified Strength And Conditioning Specialist
Advanced Physical Medicine Center, Fairview NJ
Remedies for back pain range from patches to devices to the OTC pills that people also take for a headache or a cold. And of course, many people will go to a doctor who will prescribe serious pain pills. Why opt for physiotherapy?
Dr. Berk: Most back pain is not caused from one single reason — rather, it is of insidious onset and is most likely the accumulation of small pressures to the spine over a long period of time.
Pain is our alarm system alerting us that there is a problem. Medication specifically to treat pain simply turns off the alarm system — it doesn’t address the problem. The goal of rehabilitation is to correct poor movement patterns with manual therapy and exercise. In other words, rehabilitation corrects the root of the problem.
What do you say to people who have back pain in terms of what they should do and why?
Dr. Berk: The primary goal is to evaluate that individual to find out why they are experiencing pain. Once the problem is discovered, a treatment plan is created to improve any functional deficit — range of motion, flexibility, strength, and coordination. It is imperative to empower the patient and make them realize that they can stay well by themselves and do not require the help of others. A healthy lifestyle that includes an anti-inflammatory diet and exercise are key factors to the health of the musculoskeletal system.
How long should a person go on with handling back pain before surgery is the only recourse?
Dr. Berk: Only 3-5% of patients with lower back pain require surgical intervention. By definition, patients who require surgery have progressive neurological symptoms such as muscle weakness caused by a pinched nerve. But pain is not a criterion for surgery — there are infinite options available while the patient finds a treatment option that works for him or her to address the problem.
What is the most common cause of back pain?
Dr. Berk: The most common cause is cycles of repetitive or prolonged bending, or sitting over a long period of time. The typical lower back patient is one that is de-conditioned from a sedentary lifestyle and sits in front of a computer for 40 plus hours per week.
We believe that movement is medicine. A physical therapist who studies movement has a mantra that I really like – “First move well, and then move often.” If every patient followed this prescription, lower back pain wouldn’t be the third most costly condition of our health care system, and 80% of the population wouldn’t experience it at least once during their lifetime.

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