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Top 10 Back Pain Myths
Myth: a widely held but false belief or idea
The media, internet and social media are absolutely littered with poorly evidenced misinformation and negative narratives that often get people better slower rather than speed up their recovery. Here are 10 back pain myths that irk us most!
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# 1
You Have A Slipped Disc
An intervertebral disc can herniate, protrude and extrude but one thing in certainly cannot do is slip out of place. Your discs sit in between your vertebrae which are surrounded by strong, thick, ligamentous tissue, your posterior and anterior longitudinal ligaments and these do a very good job at keep your disc where it should be. The notion that your disc can slip in and out place, paints a picture of a vulnerable spine and that you may need hands on treatment to put it back in place. This is simply, not true.
# 2
You Have A Trapped Nerve
Another strange, yet widely used phrase both societally but also in the medical field too. A nerve can become irritated, inflamed and sensitised, however, it is never mechanically trapped. Similarly to the aforementioned, slipped disc, the notion that a nerve can become mechanically trapped implies that it needs to be manually untrapped and this can lead to multiple, unnecessary, costly, hands-on sessions.
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# 3
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Your Spine/Pelvis Is Out Of Alignment/Out Of Place:
Your spine, sacroiliac joint and pelvis are unbelievably strong, robust structures that undergo a lot of force on a daily basis through dynamic movement and loading. In order for your back or pelvis to be out of place or alignment you really do need to be involved in a fairly traumatic incident, for example, a fall from a great height or a care accident. Again this narrative implies somebody needs to physically realign you or put your back, back in place. All of the above provide a lovely narrative for you to keep coming back for more sessions.
# 4
You Need To Avoid Bending If You Have Back Pain:
Your back is a strong robust structure and it's main function is to bend, twist, lift and carry things, as well as protect your spinal cord. It may be that if you have significant pain with bending, you need to modify your activities for a short period, however, re-training your back to do what it's designed to do when you symptoms allow is strongly advisable. The old adage of, 'if you don't use it, you lose it', is oh so true.
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# 5
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You Need A Scan To Diagnose Your Problem:
Over imaging/scanning is a huge problem when it comes to low back pain management. There is another page on the website that goes in to far more detail on the topic. However, in the interest of keeping things short and sweet, scans correlate poorly with pain, as we age we all have incidental/normal age related findings on scans whether we're in pain or pain free. They very rarely change the course of treatment, in the short term, and there is evidence to suggest they lead to more days of disability, more time off work and are more likely to lead to unnecessary, invasive interventions. In addition, back pain is one of the most common things that health care professionals see and should be able to assess and diagnose you appropriately.
# 6
You Should Rest If You Have Back Pain:
Gone are the days that complete rest is recommended for back pain. Prolonged periods of rest are likely to lead to a longer prognosis. Try to keep moving as much as possible, as your pain allows, letting your back settle down, whilst doing what it is designed to do, move.
# 7
You Should Avoid Exercise If You Have Back Pain:
There are no hard and fast, black and white rules when to comes to back pain. We are all completely different and symptoms vary greatly from person to person, in turn, what works well for one person may not for another and vica versa. With this in mind, there is nothing you are not allowed to do if you have back pain (unless you've had a fracture or surgery with specific protocols in place). The only time that you need to stop exercising with your back pain is if you feel that it correlates with making your symptoms worse.
# 8
Your Back Pain Is Linked To 'Poor Posture':
'Sit up straight', 'stand up tall', phrases we all a very accustomed to hearing as we grow up. Maintaining 'good posture' may well be linked to creating a good impression or portraying self confidence, but the evidence tells us that it certainly isn't linked to pain. Studies have been done on individuals with stereotypically 'good posture' and stereotypically 'bad posture' and found that there is no difference in the levels of pain they experience. There is a whole video on the topic on The YouTube Channel.
# 9
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Your Back Pain Is Linked To Poor Lifting Technique:
Similarly, to 'poor posture' there is no evidence to suggest that if you lift things with a flexed or bent spine you are more likely to get back pain than if you lift things with the traditional straight back, bent knee approach. Much of this narrative has come from cadaver studies, that in no way represent how we move when we're alive. Of course, if you bend over and lift something very heavy and you are not conditioned to do it, it could be painful, in the same way that if you tried to bicep curl a weight that you weren't used to, your could injure yourself. Once again, your back is designed to bend and lift, you just need to condition it, to do so!
# 10
You Need 'Hands On' Treatment To Get Better:
Your thoughts and beliefs about how a treatment will affect you have a huge impact on whether they do or not, i.e. if you think a massage will help and improve your back pain, it probably will. There is some evidence to suggest that hands on treatment can help with short term pain relief. There is also some evidence to suggest that it is no more than a placebo, which is fine, if it helps with your symptoms. Just be informed about that fact, nobody is able to release fascia, break down scar tissue or realign you with manual therapy.
