If you have been dealing with back pain recently, know that you are not alone. About 80% of people will experience an episode of back pain at some point in their life. Unfortunately, there are a lot of common misconceptions out there about back pain, many of which are reinforced by the media, industry groups and well-meaning clinicians. As a result, these unhelpful beliefs can spiral into unhelpful behaviours. Things like avoiding certain movement or postures, protective mechanisms such as bracing the core, and limiting meaningful activities like social gatherings or everyday tasks. Back pain can feel extremely scary, but it does not have to take over your life.
Here are 10 helpful facts that every person should know about low back pain.
1. Back pain can be scary, but it’s rarely dangerous
Although back pain can be very worrisome and stressful at times, it is rarely a serious, life-threatening medical condition.
2. Getting older is not a cause of back pain
Age is not indicative of pain. We often hear about getting older can worsen back pain, but there is no evidence to support this. Most episodes of pain improve over time and do not get worse as we get age. In fact, the highest prevalence of back pain occurs between our 30’s and 50’s, and starts to decrease as we get into our golden years.
3. Persistent back pain is rarely associated with serious tissue damage
Our backs are very strong and resilient. Any tissue damage that occurs in the body heals a lot faster than we think. Within 3 months, our tissues are on their way to being healed. A majority of back pain begins with mundane, everyday movements, which means it may be more related to stress, fatigue, lack of exercise, previous experiences and fears. Our nervous system has a funny way of turning the volume of pain up or down based on these factors, making the back more sensitive to movement and loading.
4. Scans rarely show the cause of back pain
A lot of scary-sounding things are reported on the scans that aren’t necessarily associated with the pain being felt. Things like disc bulges, degeneration, herniated discs, and arthritis. What these reports don’t mention is that these findings are also commonly found in people without back pain. Unfortunately, when people with back pain are told that these findings are the cause of their pain, they begin to believe their back is damaged and tend to become fearful and avoidant of activities that they love. Instead, try thinking about these findings as ‘wrinkles in the back’, common findings in the majority of spines (with or without pain) rather than debilitating, scary conditions.
5. Pain with exercise and movement doesn’t mean you are doing harm
When someone experiences pain, the spine and surrounding muscles can become very sensitive to touch and movement. Back pain during exercise is a reflection of this hypersensitivity, not damage of the tissues. In fact, exercise and movement are one of the best things you can do to help treat back pain! It is safe and normal to feel some pain when you start moving, and it often will settle with time as you become more active. Exercise is also beneficial in relaxing the muscles, improving mood, and strengthening the immune system. Regular exercise helps keep you, your body and your mind strong and healthy.
6. Back pain is not caused by poor posture
This may be hard to believe, but there is actually no specific posture that has been shown to prevent back pain! Everyone’s body is different, so some might find it painful to be slouching while others will find sitting upright to be more uncomfortable. The current research tells us that how we sit, stand and bend does not cause back pain, even if these movements are painful. Having variety in postures throughout the day is actually very healthy for the back and is highly recommended. It is safe to perform everyday tasks like sitting, bending and lifting with a round back and a straight back!
7. Back pain is not caused by a ‘weak core’
Having weak ‘core’ muscles is actually not associated with back pain. In fact, people with back pain often over-activate and tense their ‘core’ as a way to protect themselves from the pain. It sounds counterintuitive, but this can actually be worsening your back pain! Imagine moving with a clenched fist after spraining your wrist – how painful would that be!? It is important to be able to have control of your ‘core’ muscles and use them when needed, but constantly bracing and guarding, especially when in pain, isn’t always helpful. Learning to relax your back and ‘core’ during daily tasks can be helpful.
8. Backs do not wear out with everyday loading and bending
Our backs are built to move, bend, twist and lift. Loading the back is actually what will make it stronger, healthier and more resilient. Sure, someone can strain their back if they lift something heavier than what they’re used to, but that does not mean this movement is bad for you and should be avoided. Gradual and regular loading of the back can help to build tolerance and is completely safe. Think about people who begin to start running after spraining an ankle – we need to load the joints again even after an injury, to make them stronger and healthier.
9. Pain flare-ups don’t mean you are damaging yourself
Pain flare-ups are scary and frustrating. Often times, they come on with simple, everyday movements and not from an actual injury. Similar to headaches, common back pain triggers include things like stress, tension, low mood, poor sleep, low water intake and lack of exercise. Improving these factors can help to prevent or lessen the intensity of flare-ups.
10. Injections, surgery and strong drugs usually aren’t a cure
Spine injections, surgery and opioids usually aren’t very effective for back pain in the long run. More often than not, the risks and negative side-effects outweigh the pain-relief experienced. Treating back pain through a more conservative approach is not only more effective, but cheaper and saf
er than these extreme measures. Incorporating patient-centered education, physical activity, manual therapy and ways to improve mental health will be more beneficial in the long term.
Reframing some of these beliefs about back pain and creating a positive mindset will help to decrease pain levels, build confidence and lessen the fear. Back pain does not have to be as scary as we make it out to be!