Breaking Down 11 Myths About Lower Back Pain
As populations across the world expand and grow older, lower back pain (LBP) is becoming increasingly common.
Statistics indicate that disability from LBP has increased over 50% since 1990, most notably in low-to-medium income countries.
So it seems that many people will experience LBP at some point in their lives. For most people, this will resolve within four to six weeks. For some, the pain may be more persistent.
Unfortunately, there are a lot of myths surrounding LBP, particularly about how it should be approached and treated.
Dr Kerrie Evans, Healthia’s education and research officer and expert in spinal pain, breaks down some of the LBP myths.
Myth 1: LBP indicates a slipped disc
While we might hear about slipped discs or a person’s back being ‘out of whack’, Dr. Evans points out that our spines are very strong and stable and that these things do not actually occur in a mechanistic sense.
What often happens with a disc injury and back pain is that it can feel like everything is out of place or stuck – but it’s not literally the case.
Myth 2: LBP can be caused by a pinched nerve
Dr Evans says nerves do not become literally ‘pinched’, but rather inflamed or irritated. This doesn’t require surgery – except maybe in rare cases of nerve damage where there is a progressive and severe loss of control and sensation.
Myth 3: you need a scan to accurately diagnose the cause
Scans are mostly unnecessary. For most people with LBP, there is no defined structural cause, says Dr Evans, and scans will not change how it’s managed. Scans can also have a negative psychological effect. Dr Evans says that people who undergo scans often have worse pain outcomes – likely due to the message that something must be seriously wrong with them to need a scan.
Myth 4: bed rest brings relief
Bed rest for back pain was a traditional approach, but it’s no longer recommended as there is no evidence it brings relief. The recommendation today is to avoid bed rest, and to return to normal activities as much as possible.
Myth 5: a series of treatments will fix my back pain
Treatments such as physiotherapy are not designed to ‘fix’ LBP. The aim of such treatments is to improve function, and to prevent any disability from getting worse. They certainly do not put your back ‘back into place’ as is often thought!
Myth 6: you should avoid all exercise
Exercise can be very beneficial for relieving LBP, whether the pain is acute or chronic. The best exercise program, says Dr. Evans, is one that keeps you moving, and at least does not make the pain worse. It should also be something you enjoy as then you are more likely to keep it up!
Myth 7: surgery is required for a disc injury
Fewer than 5% of people with disc injuries will need surgery – although Dr Evans argues it is probably way lower still. She says even demonstrable disc changes respond well to conservative treatments, such as physiotherapy and exercise.
Myth 8: you need to develop the right posture
There is no ‘perfect posture’, says Dr Evans, and urging people to correct their posture is usually not helpful. However, sitting or standing in one position for a long time can exacerbate pain. A good general guide is to change positions every 15-20 minutes, and to monitor how you feel.
Myth 9: children don’t get LBP
While LBP is low in children, it can still happen. It tends to be higher in adolescents than in younger children though.
Myth 10: a scoliosis diagnosis means having a bad back forever
Scoliosis is a condition where the spine curves sideways. Dr Evans says there is no relationship between scoliosis and LBP – so if you’ve been diagnosed with this condition you don’t need to worry that you’ll always have low back pain as a result.
Myth 11: daily pain medication is fine
Dr Evans believes it’s not a good idea to be taking pain medication every day for back pain. However, she also says it’s important to speak to your GP about this.
So, what is the best treatment for LBP?
While there is no single treatment for all cases, most lower back injuries respond well to tailored conservative treatments. This includes physical therapies and movement-controlled exercises (such as pilates or yoga), stretching movements, and regular walking.
“Physiotherapists are well-placed to offer good care for LBP, both acute and persistent. This includes having the time (through 30-60 minute sessions) to understand your pain and develop specific collaborative goals with you,” Dr Evans says.
Contact us to book a time with one of our expert physiotherapists for lower back pain care.