An amazing article by a renowned pain expert Peter O’Sullivan recently appeared in the British Journal of Sports Medicine. The reason we’re so excited about it, is it addressed some common misconceptions about low back pain.
At Revive Physiotherapy in Hamilton we pride ourselves on delivering the best care we can based on the most recent up to date evidence. There’s a lot of misinformation as well as fear mongering surrounding low back pain that doesn’t line up with years of well documented research. There’s a multibillion dollar industry surrounding selling ‘cures to pain’ so to see this type of editorial published is refreshing.
Here’s a quick summary of the main points of the article:
- Persistent back pain can be scary, but it’s rarely dangerous
Persistent back pain can be really painful and feel disabling, but it’s rarely something dangerous for your health
- Getting older is NOT a cause of low back pain.
We commonly attribute our aches and pain to age, but now the research shows that this is not the case. Pain can happen at any age and properly executed evidence-based treatments can help at any age.
- Persistent low back pain is rarely associated with actual physical damage.
Sometimes it seems that we can ‘feel’ things going out of place. The truth is, we aren’t great at deciphering the cause of our sensations. Most instances of low back pain aren’t due to a specific injury, but due to many other factors such as stress, tension, fatigue, inactivity, or new activities that our body isn’t used to yet.
- Imaging such as x-ray/MRI rarely shows the real cause of low back pain.
Many people want an x-ray or MRI to find out the ’cause’ of their low back pain. It gets sticky because ‘abnormal findings’ appearing on your scan also appear on the scans of people who don’t have back pain. Scans are best left to situations where ‘Red Flag Symptoms’ exist.
- Pain with exercise and movement doesn’t mean you are doing harm.
When pain persists, the muscle and tissue around the spine can become sensitive to touch and movement. The pain you may feel with movement is more indicative of how sensitive you are to that position than how ‘damaged’ your back is.
- Back Pain is not caused by poor posture
This is a big one. We get lots of calls and visits from clients who attribute their pain to their posture. The good news is that how we sit, stand, and move doesn’t cause our back pain, even if those positions may hurt. It’s safe to relax into various positions throughout the day.
- Back pain is NOT caused by a weak core.
Another big one. People are often hard on themselves and attribute their back pain to a weak core. But, very often people with low back pain actually TENSE their core more than those without low back pain. Sure you need to be strong for day to day activities, but with back pain it’s better to learn to relax those muscles than to guard and create more tension.
- Backs do not wear out with everyday repetitive use or bending.
Muscles get stronger when used and so do backs. Get out there, get strong, and have fun
- Pain flare ups don’t mean you’re damaging yourself.
Pain flare ups are scary, but usually aren’t associated with a specific injury. Flare ups have more to do with poor sleep, low mood, lack of movement, new movements, worries, or stress. The trick to low back pain? Try and stay calm, move lots, and find ways to manage lifestyle factors that can trigger flare ups.
- Injections, surgeries and drugs usually aren’t a cure.
Injections, Opioids, and surgeries come with inherent risks and often aren’t associated with better outcomes or reduced pain. Low-risk ways to put yourself in charge of your pain are the key.
It’s a lot to take in, and a lot of new and difficult information to digest. It doesn’t make it easier when lots of us have been hearing the opposite from our health care practitioners for many years. However, the evidence is both refreshing and hopeful. It means you can be in control of your body and confident in your ability to be active without fearing damaging yourself.