Andrew Terry Registered GOsC Osteopath – blog post produced and written by GOsC Registered Osteopath Andrew Terry.
We all know someone who has is suffering from, or has had back pain at some point in their life. It is one of the most common sites for pain in the body, affecting about a third of the UK population each year. It is still the most common cause of work absenteeism, making up about 40% of all sickness and costing the UK economy around £10 billion each year. And one of the reasons behind this is that we have done such a poor job at educating people about what pain is, and what we should do when we get back pain in particular. With this in mind, here are 10 of the most common myths about back pain.
Myth 1 – Bain pain is caused by poor posture
My patients probably get bored of me saying this, but there is no such thing as bad posture, but just a body that lacks movement. That’s not to say that I don’t like helping people with their posture, and I often give tips on how they can improve it if they want to. However poor posture is a poor predictor of pain and pain outcomes.
Myth 2 – Low back pain is a serious medical condition
Despite the fact that low back pain in particular can be seriously debilitating, the majority of the time it is NOT a serious medical condition. I can’t emphasise this one enough. There are a few exceptions to this, and I will address these in another blog coming soon on cauda equina syndrome and other serious back pain pathologies, but these are a minority. That’s not to say that back pain isn’t distressing and it can definitely be agony, but it’s not a life threatening condition and the vast majority of people are get back to full function relatively quickly.
Myth 3 – Pain related to exercise and movement is always a warning that harm is being done to the spine and a signal to stop or modify activity
So here I want to talk a little bit about what pain actually is. Pain is a GOOD thing, despite it being very annoying. It’s essentially your brains way of telling you that it’s picked up on a possible danger signal, and is trying to let you know you should be a bit careful. Just because it’s telling you to be careful, doesn’t mean you’ve done any damage, even when the pain is high. You may want to stop working out that particular day, but continuing to move dynamically through different ranges is actually really good for you. Following on you actually want to continue to move through what I like to call comfortably uncomfortable ranges of movement, movements that are around 3-4 on the pain scale, in order to let your brain know that everything is in fact ok and it doesn’t need to be worried anymore. From there increased graded exercise is actually really good for your body and an important part of the recovery process.
Myth 4 – Low back pain is caused by weak “core” muscles and you need to have a strong core in order to protect yourself against potential back issues
You could argue that the opposite to this is actually true. Having weak back muscles does actually cause low back pain, and in fact some of the literature out there now suggests that some LBP is caused by the muscles in the back being unable to relax. This isn’t to say that having strong muscles isn’t important, but you want them to be functionally strong, which means you want them strong enough, or perhaps a little bit stronger than for the activities you use them for.
Myth 5 – Repetitive strain on the spine leads to wear and tear
Again the opposite is true on this one. Our bones LOVE load and putting it through graded stress is actually really good for them, making them stronger and decreasing the chances of conditions such as osteopenia and osteoporosis.
Myth 6 – Pain flare-ups area are a sign of tissue damage and you must rest to recover
We need to go back to what pain actually is for this one. Usually a pain flare-up is related to the fact you’ve suddenly increased your activity levels, or you’ve had a stressful day or you’re in a bad mood. Just because it’s related to your mood doesn’t mean your pain is any less real, or “it’s all in your mind.” If you’re experiencing it, it’s real, 100% of the time. But it means that the way to comb at it is actually through doing things that might improve mode, like exercise, or mindfulness activities.
Myth 7 – I need to have a scan to determine what’s causing my back pain
Here is when seeing a specialist can help you. As I mentioned early back pain is not a serious medical condition, and therefore the majority of the time scans are not necessary. Sometimes they can actually make things worse, as scans have become so good that they show you everything and can often produce red herrings. By going to a specialist like an osteopath, they can go through your symptoms and decide whether or not your symptoms warrant further investigation.
Myth 8 – Persistent low back pain is always related to tissue damage
In the case of persistent low back pain, one of the most common causes is actually related to something called central sensitisation. In most cases of central sensitisation, the body has actually healed, but the brain still thinks there is a problem. This is sometimes caused by fear that you may cause yourself damage when you move, a lack of activity post injury, your past experiences with pain and even your memories and experiences of others around you who have had low back pain, after all if someone you know has had horrible low back pain and you’ve been worried for them, if you then get back pain that can worry you too and might make your brain get overly sensitive and try to protect you by generating pain.
Myth 9 – Low back pain will become persistent later on in life
The opposite is actually thought to be true now with some studies suggesting that prevalence tends to decrease after the age of 40. Also as we get older, the centre part of our disc called the nucleus pulposus which is the part that causes herniations and bulges actually shrinks and disappears so we are no longer as prone to some forms of back pain.
Myth 10 – I need to have surgery to get rid of my low back pain
As with the myths about scans, the idea that surgery will cure all your pain is another myth we must do our best to eradicate as what we see in scans is not necessarily the cause of our pain. If you’re thinking about going down the surgical route always speak to a trained specialist who can discuss with you your concerns about your pain, as they may be able to help you out of pain without surgical intervention. As I say to a lot of my patients, surgery can always be an option, but once you’ve exhausted the alternatives as once you’ve had surgery you can’t come back from the changes they’ve made to your body.
The information from this blog was taken from the “Back to basics: 10 facts every person should know about back pain” O’Sullivan, Peter et al study.
If you’d like to discuss more with a medical professional about your back pain then do not hesitate to contact one of our trained therapists at Bodylogics.