Debunking the many myths of back pain

During one of my social media breaks I stumbled across an informative article talking not only about the nature of back pain but some common perceptions about back pain. Here are the Coles Notes with a dash of commentary from yours truly.¹

1. Back pain is common (true)

The bad news is that back pain is a very common thing affecting up to 84% of the population at some point in their life. The good news it is seldom the result of a serious or harmful origin (as low as 1-2% of all back pain cases can be attributed to serious cause). Similarly, back pain is equally common across all ages young and old. Most episodes of back pain recover quickly with or without treatment. Some may encounter a recurrence of symptoms but don’t panic it is unlikely serious in nature.

2. Scans and images are needed and well-linked to recovery (myth)

Just because you have back pain, doesn’t mean you need an MRI to find out why. Research shows that unless a serious condition is suspected (fracture, cancer, bone infection) there is no need for special images. This point is too important to paraphrase:²

“The problem with scans is that they will almost always show something and much of this ‘stuff’ is poorly linked with back pain. Research shows that people who don’t have back pain have disc bulges (30% of 20 year olds up to 84% of those 80 years of age), disc degeneration (37% of 20 year olds increasing to 96% of 80 year olds), disc protrursion (29% of 20 year olds increasing to 43% of 80 year olds) and facet degeneration/arthritis (4% of 20 year olds to 83% of 80 year olds)”

3. The back is resilient (true)

We do not need to guard and protect our back. No, you haven’t slipped your disc, or put your pelvis/joint “out”. When in pain, it is possible to feel as if things are “out” or “slipped” and when adjusted it may feel like things are “back in” but science shows that this sensation is due to changes in the nervous system that desensitize pain and relax muscles. And, while core exercises are important, they have been shown to be no more effective than other exercise programs (walking) for treating back pain.

4. Your back is not designed to bend and lift (myth)

Your back is designed to move and lift! However, as with any muscle, you need to be conditioned to do so. The same way you get sore feet after walking too far, a person can get back pain from lifting something too heavy, too awkwardly or too many times. There are lots of different lifting techniques that can be safe and effective but you must be practiced and adapted to be able to lift safely. Your physio/chiro/massage therapist can help you out finding proper lifting techniques.

5. Back pain does not mean damage (true)

Most believe pain equals harm. This is not always the case. There are many factors that can influence pain such as: physical factors (guarding/avoiding movements), psychological factors (fear of damage/not getting better, mood, stress), health factors (fatigue, low energy), lifestyle factors (sleep, inactivity, being overweight), social factors (relationships at work/home, work satisfaction, stressful life events). Thus, based on any combination of these you can feel more or less pain despite the lack of tissue damage. Then why does your back light up with picking up your keys? Often times the structures are sensitized by one or many of the above factors and that one movement brought pain to the surface.

6. Activity and movement are detrimental for speedy recovery (myth)

During back pain episodes many people think they should rest till it gets better. Research shows that staying active and gradual returning to normal duties (work and hobbies) is important in helping recovery. Similarly, prolonged rest actually makes pain levels worse, increases disability and creates longer absences from work.

7. Exercise is good for back pain (true)

Exercise is helpful and the best kind of exercise is the kind you enjoy. Most are often told to avoid exercise in favor of low impact activities. However, it is important that you perform exercise in a relaxed manner progressing gradually back into it. If you feel stiff afterwards, it doesn’t mean you’re doing damage but that your body is not used to the activity.

8. Strong meds are better than weak ones (myth)

Research suggests that strong painkillers are no more effective than “less strong” pain killers in treating back pain. Opting for simple over-the counter options can be equally effective and less harmful than prescription medications. Always consult your GP before taking anything new.

9. Beware of commercial fads/products (true)

Bottom line with these is that most have not been studied and proven so the potential to waste money is quite high. Even those tested have not yielded the results they often claim.

10. Back pain is irresolvable (myth)

Keeping in mind that back pain is multifactorial it needs to be treated similar to any other kind of pain. By considering different factors relevant to your case while at the same time engaging in graduated activity such as exercise, relaxation, socialization are all important components of recovery.

Conclusion (true)

Overall, this is good news. Back pain is treatable and human backs are built to move and recover. For an individual approach to managing your low, mid or high back pain, the skilled team of manual therapists here at Arbutus Physiotherapy and Health Centre can help you out! Give us a call.