Up‑front cost vs long‑term results: why an In-depth assessment makes financial ense

My low back pain rehab programs require an initial financial outlay that may appear 'expensive' to some at first sight.

However, when you consider the real cost of continuing as you are, the value of a thorough assessment and personalised rehab program is easier to appreciate.

The cost of doing nothing isn't always obvious at first:

• You become fearful of moving freely because you're not sure what will cause another flare-up
• You stop training properly, unsure of which exercises could make things worse
• Your capacity decreases (which can actually make future flare-ups more likely)
• Your confidence erodes, which changes your relationship with your body
• It becomes harder to exit the downward spiral of becoming weaker and more fearful of movement

So, if doing nothing isn't the answer, what about generic rehab?

Well, depending on what this involves, it can also have a cost, even if it seems 'free' because it's covered by your insurance.

Standard low back pain rehab usually targets your symptoms without ever addressing the root cause. You probably already know from first-hand experience that a typical physical therapy session that's covered by your insurance is divided roughly equally between:

1. Some kind of passive treatment, where you lie on a table while someone or a machine (TENS, ultrasound, etc.) does something to you, requiring no participation on your part.
2. Mobility, stretching and some generic core exercises.

Passive treatment modalities have notoriously poor evidence regarding their efficacy yet they're still widely used in clinical settings because they're so convenient to administer. They may reduce your symptoms temporarily, but they do nothing to help you move in a way that reduces stress on your spine, allowing it to heal and become more resilient in the long term.

And, the standard mobility, stretching and core exercises for 'non-specific low back pain' will help some people, but not others. For some people they will actually exacerbate their pain. That's because low back pain isn't 'non-specific' - it's highly individual. What works for one person will trigger another's symptoms.

I recently had a client who had done his quota of 10 physical therapy sessions with a similar structure to that described above with no improvement of his symptoms. In addition to his 45-minute sessions, he had spent another 2 hours (total) driving to and from each session. What's more, driving was one of his main pain triggers! Yet, when his back pain didn't improve, no alternative approach was proposed.

Through no fault of his own, he continued with the treatment that was paid for by his insurance and provided to him by the professionals that he trusted. Then his insurance ran out.

He had lost 27 hours of his time, the opportunity cost of not having done something more effective and a significant amount of hope that he would ever find a solution. Not only that, but he still didn't understand the cause of his pain or how to prevent future flare-ups.

If you're not shown what your precise pain triggers are, and coached on how to avoid provoking them then it's almost inevitable that you will have another flare-up at some point.

The goal of a McGill Method low back pain assessment isn't to provide temporary relief of your symptoms. It's to identify the postures, movements and loads that provoke your pain and teach you how to go about your life (at home, at work, in the gym) without provoking your pain.

When you do an assessment with me, I want you to finish the session with:

• increased awareness of how your personal history and lifestyle have contributed towards your back pain
• a clear understanding of what your precise pain triggers are
• movement tools you can use to protect your spine and allow it to heal
• knowledge of correct exercise technique to address any deficits revealed during the assessment, for example, in muscular endurance, stability and/or mobility, with the goal of reducing stress on your spine and making it more resilient
• confidence that you're on the right path and have responsive support in the event of any setback

This is not a 'one size fits all' approach, and it takes time. This is why the assessment takes 3 hours to complete.

When you've been suffering with low back for months or even years you need clarity about what you can and can't do to get you moving in the right direction.

If getting a McGill Method assessment helps you finally understand your low back pain and teaches you how to avoid provoking it while getting on with your life, the savings in time, money and opportunity cost are likely to end up being many multiples of the initial investment.