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Nov 20

Back pain myths and truths

Back pain and exercise

Do you experience low back pain? Do you want the good news? Nearly every person in the world experiences low back pain at some stage during their life. Sometimes the pain doesn’t go away. Back pain that continues on for more than about a month is considered as chronic pain. There are many reasons why our pain experience can be better or worse than other people. In our previous blog we talked about pain itself. You can read more about it (Pain is Pain, right?!).

Below are some of the very common myths that are told about back pain. The words are unhelpful and in some ways quite harmful. Sometimes well meaning advice is just simply wrong.

Myth 1 – Rest is what you must do when your back is really bad. Exercise will make it worse.

back pain rest

Some rest is important for acute pain but too much is unhelpful

Truth

Whilst decreasing the load on a really angry back by having short periods of rest may be beneficial in the short term it will not help in the long term.

The back is designed to move. Therefore gentle movement especially walking is crucial to recovery – the sooner the better. Movement improves circulation, decreases muscle spasm and calms the pain response. What often goes wrong is that people do too much movement and cause a flare up. That’s all it is. It will settle again. Speak to the physio’s at Vital Core. Managing your pain with movement and exercise is what we do best.

Myth 2 – Stretch it out. The muscles are just tight and need lengthening.

Stretching and back pain

Flexibility, strength and movement are key. Don’t over do any of it.

Truth

Gentle stretching can be a great part of a movement program for low back program, but it’s just a part. Rarely is the pain caused by a tight muscle. Excessive stretching can even worsen symptoms. We need a balance between muscle flexibility (or length) and strength (and control). Too much of either isn’t useful.

Myth 3 – My core just isn’t strong enough

back pain and abdominals

Wash-board abdominals doesn’t protect you from back pain

Truth

The core is an essential part of the body. When strong it helps us transfer forces through the trunk, allows us to hold ourself upright. It can help us with our general strength and well being. However there is a belief that making our core super strong will fix all back pain. It won’t. As we said above we need to be able to move. We need balance between strength/ control/ flexibility/ muscle length. If we focus solely on making our core ‘super strong’ we run the risk of becoming very stiff and rigid. This rigidity causes tension and potentially pain in our back and can cause a number of other issues too (such as pelvic floor pressure, gut issues, hip pain).

Myth 4 – We have a family history of bad backs – it’s just genetic

back pain and genetics

Genetics predetermine eye colour and some illnesses, but not back pain.

Truth

There are diseases that are controlled entirely by gene’s such as (e.g thalassemia). There are other diseases that are influenced by gene’s but there are many other influencing factors that (together) determine the outcome.  If your dad has had a “bad back” since he was 20 and stopped exercising at that age because of it and now at 70 is unable to walk around the block or pick up his grand kids because of it – will that be your outcome when you hurt your back working in the garden at 30? Well it depends how you manage it. It depends on the advice and support you are given in the early days. The short answer is, no. it doesn’t have to be your outcome. You are not your parents.

Myth 5- The scan (insert Xray, CT, MRI…) show I have a spine of a 70 year old!

Back pain and imaging

Tissue damage does not correlate with pain

Truth

The power of words.

Scans can be extremely helpful to rule out serious conditions such as tumours, or major nerve compression (when I say serious I mean can not feel leg(s) or loss of control of bladder or bowel due to the back). In those situations the scan will determine the line of treatment (i.e. surgery or not). Otherwise scans do nothing to aide treatment and get you back to what you are missing out on because of your pain.

Most scans on everyday (no low back pain) people will show areas of bone, joint and disc degeneration or wear and tear. They are normal (common) findings. We know that images of seemingly significant tissue damage are not correlated with pain or dysfunction. Similarly, people with incredible pain often don’t have significant tissue damage.

Imaging has it’s place to help identify pathology but not as a mainstream process in the management of back pain.

Myth 6 – I have slipped disc. It just needs to be “put” back in place.

back pain and passive treatment

Passive treatments are useful for pain management as a PART of a treatment program

Truth

Discs do not ‘slip’. The pain is due to inflammation and spasm around an injured Intervertebral discs. Intervertebral discs are soft tissue structures which can heal. They may not heal perfectly, like any part of the body, so be an area that you are more likely to re-injure in the future, but this is not a permanent label for yourself: ‘I have a slipped disc, therefore I . . . . have this forever/cannot do certain things/etc’. Disc injuries are very common, and very commonly completely recovered from. If you still experience pain, it is more likely that some of your habits of posture and movements are contributing. This is where we can help. We can help work out what is going on and why you are still having pain.

Myth 7 – I’m just old, I’ve always got pain.

back pain and age

Age is no barrier to movement. Movement decreases pain.

Truth

No, no, no! Some of the strongest, most able people we know at Vital Core physio are well over 60. Your body does get stiffer as you get older. Your tendons are not as easily repaired and your muscles are not as bulky. So you need to move. Possibly even more than you used to. Let us help you!

Back pain that continues on for more than a month is considered as chronic. It is not normal. It is so important that you get a management plan in place to get you moving again. That plan needs to be based on what YOU want to do.

Don’t get stuck in loop of passive treatment. Passive treatment such as massage, joint mobilisation or manipulation is useful as a part of a treatment plan but it must not be the only treatment. It makes you feel good for such a short period of time. It doesn’t permanently change the tissues, but as we said before the condition (healthy or otherwise) of the tissues (joint, disc, tendons, cartilage) is not correlated with pain.

Vital Core can help you learn to move again and get back into the life you are missing. Call us now or book an assessment online