Five back pain myths debunked
When it comes to back pain, our knowledge of it has grown and changed a lot in recent decades. But this means that there is just much outdated knowledge still out there.
Ken Niere, a specialist musculoskeletal physiotherapist from the Australian Physiotherapy Association, is busting seven common myths he hears in practice.
1. Back pain requires extended rest
Though bed rest was often prescribed to those with back pain, Niere says continuing your daily activities is better for you.
“Many years ago, people would be in hospital for weeks because they had acute back pain,” he says.
“But they’d just become deconditioned - they would get better quicker if they were out moving around and exercising.”
Though it is important to not push yourself before you have recovered, especially if you have a lot of pain, Niere recommends a maximum of two days of bed rest so your recovery isn’t jeopardised.
“You also don’t want to do too much too early - you’ve got to respect the pain, but it’s important to do normal activities of daily living as long as it doesn’t flare up,” he says.
2. Back pain means spine damage
Since pain is a complex bodily function, many patients are confused when they learn that the tears or fractures they swear they have do not show up on X-rays and scans.
“There’s not a good correlation between lower back pain and the imaging results,” Niere says.
“People think, ‘If my pain is severe, then the damage must be severe as well’, but that’s often not the case.”
The amount of pain we can tolerate also differs, meaning that it is often disproportionate to the amount of damage.
3. Back pain always come from your back
While we might assume a sore back means that it’s the source of our pain, Niere says it often comes from tightness or damage in another part of the body.
“It might be tight hamstrings; or an arthritic hip that’s causing mechanical strain on the back, which then causes pain; or that their core muscle control is not good and that’s causing more strain on the joints and ligaments, which is causing the pain,” Niere says.
Determining the cause of back pain often requires an examination from a physio, where they consider whether habits or activities that occurred before the pain started are the culprit.
“It might be postural or inappropriate activity, or that someone spent three days in the garden and they’re not used to that amount of activity,” he says.
4. Once a bad back, always a bad back
Though back pain does have a high recurrence rate, Niere says it’s often because the pain isn’t managed well from the start.
“There’s something like an 80 percent recurrence rate in 12 to 24 months [but] it goes back to them not looking at the underlying cause of the pain,” he says.
“They treat the symptoms with rest of mediation and their pain settles down, but if their sitting posture or their tight hamstrings keeps putting strain on the back and they don’t address the underlying cause, then of course it will come back.”
But, it is possible to have a good turn-around by adopting a good program and addressing any contributing factors.
Sometimes you might need to address psychological factors too, where being convinced that you have a ‘bad back’ could contribute to the pain returning.
5. Massages fix back pain
When back pain starts, the first thought for many people might be finding the nearest massage shop to get some relief.
Although manual therapy can offer temporary relief, Niere says it’s still important to deal with the issue that caused the pain in the first place.
“It can be a bit like taking Panadol, which will give you some short-term relief, but may not necessarily address the underlying causes,” he says.
“I would be careful about only having passive therapies, whether it’s heat or manual therapy - they address the symptoms, but not necessarily the underlying causes.”