One of the most common issues we see in the clinic is people presenting with some sort of back pain, usually lower back pain. Sometimes it’s an acute injury, but more commonly it’s a long-term condition that has been grumbling for a few months or even years. Often these patients think they are doomed to failure and have been led to believe (by other practitioners, doctors, media, family) that they will have a “bad back” for life and the best they can hope for is to manage it. Sound familiar? These people are often told to avoid heavy lifting, excessive exercise or anything else that may aggravate their back. There are so many myths around back pain that have become part of normalised thinking when it comes to managing this common condition. This blog is not trying to say that back pain is not real, but rather that the current narrative around the treatment and management of pain are not helping to improve outcomes. The truth is most back issues are fixable with a sensible, progressive treatment and rehabilitation plan. Even small lifestyle changes like getting more exercise and using your back can dramatically decrease pain levels.
So, what are some of the most common myths?
You need complete rest
Usually people are told that when they hurt their back they need to completely rest and avoid movement. While in the early acute stages of an injury rest may be needed, long-term rest or movement avoided is not beneficial for back pain. A gradual increase in movement and exercise will benefit your back pain in the long-term.
Your back is weak and prone to injury
People have been led to believe that their backs are weak and susceptible to injury. This is not the case! Your spine is strong and is designed to bend, twist and lift. There is a huge psychological aspect tied in with back pain and a fear of movement can increase symptoms. The phrase “use it or lose it!” is pertinent in this case.
It’s only a muscular issue
While a lot of back issues are caused by some sort of soft tissue damage, lifestyle factors can also be a factor in chronic back pain. Stress, anxiety, depression, poor diet, lack of sleep, lack of exercise as well as the above mentioned “fear factor” have been shown to be associated with back pain.
You need a scan!
MRI’s, cat scans and X-rays are rarely needed when it comes to lower back pain. There a small number of rare conditions that can be detected by scans (cancer, infection) but in most cases they are unnecessary. In fact, if ten perfectly healthy individuals with no history of back pain had MRI’s, at least half will show signs of disk degeneration which shows that just because degeneration is present; it doesn’t automatically correlate with pain!
So having said all that, back pain is still an issue and not to be treated lightly so, what do we do? A qualified therapist or physio can help design a treatment plan that is specific to the client’s specific needs. While manual therapies (such as massage or dry needling) can be very beneficial, especially in the early stages of treatment, the primary focus should be an exercise/movement based rehabilitation plan. The therapist should also advise on any lifestyle issues as discussed above that could be an aggravating factor.
So that’s the low down on back pain and as we’ve seen, it doesn’t have to be a lifelong debilitating condition. We can dispel many of the myths that are commonplace when it comes to back pain, and focus on evidence based, exercise and movement focused rehab programmes.
If you are having back issues, please feel free to contact the clinic for an assessment.
Also, here is a nice video I did showing three simple stretches that should help if you have tightness in your back.
Rainville J1, Hartigan C, Martinez E, Limke J, Jouve C, Finno M.: Exercise as a treatment for chronic low back pain. (available at: https://www.ncbi.nlm.nih.gov/pubmed/14749199)