I’m a Spinal Specialist Physiotherapist (you can learn more about me here) and I’ve worked with every type of low back pain and condition that you could possibly imagine. These range from the usual back ache to the more severe pathologies and even the most ridiculous of back related injuries (Think Game of Thrones role play related damage!)
These are the 10 most important facts about your back pain that you need to know. In fact, I wish I could tell EVERYONE these facts. They are backed by vigorous research and you will find no old wives tales amongst them.
Read them, digest them and apply them to your current situation. If you don’t currently have back pain yourself then share them with a friend who does. I guarantee that you all know someone struggling with back pain, after all more than 70% of people will experience one or more incidences of low back pain in their lifetime.
FACT 1: A Weak Core does not cause Low Back Pain
Being able to use you body with strength and control is important in all walks of life but one of the greatest fallacies propagated over the last 15 years or so is the notion that most back pain is linked to poor core stability. In fact people in pain will often tense their back muscles as a result of the pain itself which is a bit like watering a plant that has already died. Having a set of back muscles that are tense all the time is not helpful to fluid “normal mobility”
FACT 2: Back Pain is Normal!
Most people will have some form of back pain/ache in their lifetime. Pain is very seldom linked with a serious problem to do with the structure of the spine. In fact reassuringly, LBP is often caused by regular activity or a change to our usual patterns of activity. A bit like going to the gym and using muscles that we havn’t for a while and subsequently feeling stiff and sore after for a little while. This is entirely normal .
Interestingly we know that back pain can also be linked to how stressed we are feeling and mood in general. It’s why a lot of modern back care management has taken a more holistic view. Addressing these issues often leads to improvements in our well being generally and back pain specifically.
FACT 3: Back pain does not become more “set in” with time and will not automatically deteriorate as we get older
I hear this concern almost daily as a Physio. People have picked up poor notions of back pain in the past, perhaps from previous clinicians or something they have read in an article but the science just does not support this. Back pain can be addressed and improved at any stage. I specialise in Chronic Pain (not just spinal) and within my practice I see people making improvements and overcoming pain at every stage of the pain journey and you can too.
FACT 4: Poor Posture does not predict that you will have back pain
This one is a real bugbear for me because it leads to people being fearful of moving normally within the boundaries of every day living. Don’t even get me started on health and safety and manual handling courses at work which are designed to teach you the “correct way to pick things up” I have even heard one tutor pleading with people not to pick pencils up from the floor in case it led to catastrophic disc injury!
Of course there are some common sense approaches one should take when tackling a heavier than normal load to pick up but my point is: It’s safe to slouch on the sofa or the chair or to let our shoulders round whilst playing computer games just make sure that you change positions regularly so that you aren’t staying fixed in one position.
FACT 5: Back Scans cannot predict your prognosis
Back scans or MRI tests are used in very particular back/leg pain presentations. They can show us the structure of the spine but they cannot show pain or how much the low back pain is impacting on your quality of life. Often they show incidental findings which are of no concern but can add to the patients fear or worry.
Fact 6: Spinal Surgery, Injections or long term very strong medication use aren’t usually a cure for most presentations
There are many complications that can arise following spinal surgery and the research has shown that surgery should be used as a last resort when all other conservative measures have failed. Taking control of your symptoms with a positive holistic plan to include physiotherapy and exercise has proven to be the most effective form of treatment for most back issues. Becoming reliant on super strong drugs have also been shown not to be effective in the long term management of back pain.
FACT 7: Back pain when moving or working out does not mean you are creating more damage
When you are experiencing an episode of back pain, the nerves around the back become more sensitive, the muscles get tighter and the spine itself becomes sensitive to even light touch. This is normal. Therefore when we exercise and move within these boundaries, it can be uncomfortable. This does not mean however that you are causing more damage to your back.
FACT 8: Backs do not wear out with normal activities of daily living including exercise
In fact studies have shown that those people who take regular exercise are less likely to experience back pain and if they do get an episode that they are more likely to make a quicker recovery.
FACT 9: Manual Therapy or manipulation of the spine is essential in order to overcome back pain
It’s true that this form of treatment can be really helpful in treating episodes of back pain. It’s also true that these treatments aren’t the only way of overcoming back pain. In fact numerous studies conducted have advocated a holistic, exercise based plan over a passive manipulation only treatment plan.
FACT 10: Complete rest is not the best medicine for Low Back Pain
In fact motion is lotion as a Physio friend of mine likes to tell her patients but it’s so true. Keeping the back moving and completing some light range of motion exercises when in pain helps to reduce the sensitivity of the nervous system and ease tight muscles
Summary
I teach my patients a common theme when dealing with back pain – that theme being that pain does not necessarily indicate catastrophic damage and that movement is good. It really is as simple as that. Sometimes pain can be scary and disabling and often this is the stage at which people seek help from their local physiotherapist, osteopath or chiropractor (and you can get hold of me here https://www.mtphysioclinic.co.uk/ if you’d like some one to one help)
Your main goal is to take control of your pain by remaining positive and exercising a little in order to keep the back mobile which in turn will reassure your nervous system and brain that everything is ok. Do this and in the majority of cases you’ll soon be back to doing the things you love