10 myths about Low Back Pain & 10 facts you should know

Have you ever had an episode of low back pain? Well, you are not alone!

Low back pain (LBP) is a common condition that affects 80% of the population at some point in their lifetime. At any point in time, 30% of people are experiencing low back pain. It is also the leading cause of disability worldwide and is often associated with costly, ineffective and sometimes harmful care. Many studies have identified that unhelpful beliefs about low back pain are associated with greater levels of pain, disability, absenteeism and medication use.

What are unhelpful beliefs about low back pain? You might be surprised to know that many commonly held beliefs about LBP do not stand up to scientific scrutiny. Below are 10 myths about LBP and the science behind them.

Myth 1: LBP is usually a serious medical condition.

Fact : LBP is not usually a serious condition. Less than 1% of LBP presentations indicate a serious condition that requires medical intervention.

Myth 2: LBP will become persistent and deteriorate through life.

Fact: Most episodes of LBP recover and LBP does not get worse as we age. Evidence based treatments such as physiotherapy and massage therapy can help at any age.

Myth 3: Longstanding LBP is always related to tissue damage.

Fact: Backs are strong. If you have suffered an injury, tissue healing almost always occurs within 3 months. If pain persists past this time, it usually means there are other contributing factors. Beliefs, fear of movement, sleep, stress and recovery expectation can all influence ongoing pain.

Myth 4: Scans are always needed to detect the cause of LBP.

Fact: Scans are only helpful in a minority of people. Scans can reveal some scary sounding conditions like disc bulges, degeneration and protrusions. Unfortunately, the reports do not say that these findings are very common in people without back pain as well, and do not predict pain severity.

Myth 5: Pain related to exercise and movement is always a warning that harm is being done.

Fact: When pain persists, it is common that the structures around the spine become sensitive to touch and movement. Pain during movement reflects how sensitive your back structures are, not how damaged you are. It is safe and normal to feel some pain when you start to move and exercise. This usually settles as you get more active. In fact, exercise and movement are one of the most effective ways to treat back pain.

Myth 6: LBP is caused by poor posture when sitting, standing or lifting.

Fact: How we sit, stand and lift does not cause back pain. In some cases, it can exacerbate sensitive structures but overall a variety of postures and movements are healthy for the back.

Myth 7: LBP is caused by weak ‘core’ muscles and having a strong core protects against future LBP.

Fact: Weak ‘core’ muscles do not cause back pain. In fact, people with back pain often tense their core muscles more than usual as a protective response. Being strong is important when doing heavy tasks but being too tense all the time is not helpful either. Learning to relax can be just as important as learning to activate your core.

Myth 8: Repeated bending and lifting results in wear and tear and tissue damage.

Fact: The same way that lifting weights makes muscles stronger, moving and loading the spine makes the back healthier and stronger. So activities like running, twisting, bending and lifting are safe if you start gradually and practice regularly.

Myth 9: Pain flare ups are a sign of tissue damage and require rest.

Fact: While pain flare ups can be very painful and scary, they are often not related to tissue damage. Common triggers are poor sleep, stress, tension, worries, low mood, inactivity or unaccustomed activity. Controlling these factors can help prevent exacerbations. If you have a pain flare-up you are not sure about, seek your physiotherapists advice but also try to stay calm, relax and keep moving!

Myth 10: Treatments such as strong medications, injections and surgery are effective and necessary to treat LBP.

Fact: Spine injections, surgery and strong painkillers are often not very effective for persistent pain in the long term. Finding low-risk ways to put you in control of your pain is the key.

In summary, low back pain is a common occurrence for most of us at some point in our life. Arming yourself with the facts can help your recovery. At Malvern Physiotherapy Clinic, we are experienced at assessing low back pain and helping you manage your recovery to get you back to pain free living.

Written by Alisa McLachlan

Specialist Musculoskeletal Physiotherapist

Reference:

P O’Sullivan, JP Caneiro, K O’Sullivan et al (2019) Back to Basics: 10 facts every person should know about back pain British Journal of Sports Medicine E pub ahead of print. Doi:10.1136/bjsports-2019-101611

Published September 10, 2020