The Truth About Back Pain

Did you know that back pain is one of the most common causes of general medical practice visits? Somewhere between 60-80 percent of us will experience back pain during our life, and as many as 45 percent have one or more episodes of back pain in a year. Women and men are equally vulnerable. In recent years, knowledge about back pain has improved significantly, but the problem has not diminished for that reason. There’s more focus on back pain than ever before, and the tabloid newspapers are spitting out intimidation propaganda and misleading headlines as if they were paid to do it.. Wait a minute… They actually are… The list below shatter many myths about back pain, and I hope you get a positive surprise from reading them.

The text is based on the British Journal of Sports Medicine’s Instagram post “Back Facts” and summarizes much of what we know about back pain today.

1. Prolonged back pain can be scary, but is rarely dangerous.

Prolonged back pain can be stressful and disabling, but is rarely life-threatening and it is highly unlikely that you will end up in a wheelchair.

2. Getting older does NOT cause back pain.

Although many people believe and worry that getting older can cause and / or make back pain worse, research does not support this and evidence-based treatment can help at all ages.

3. Prolonged back pain is rarely associated with severe tissue damage.

The back is strong! If you have had an injury, tissue healing will occur within three months. If the pain continues beyond this, it often means that other factors come into play. Many back problems begin without injury but with simple everyday movements. This can be related to stress, tension, fatigue, inactivity or unfamiliar activities that make the back more sensitive to movement or strain.

4. Imaging rarely shows the cause of back pain.

Imaging is only valuable in a minority of the population. Various images and scanners can show many scary things such as disc herniation, bulging discs, degeneration, inflammation, etc. These findings are also not uncommon in people without back pain and therefore give a bad indication of how much pain you have or how handicapped you are. Images can also change, and it turns out that most disc herniations shrinks over time.

5. Pain during exercise and movement does not mean you are doing damage to your back.

When pain persists, it is common for the spine and surrounding muscles to become very sensitive to touch and movement. The pain you feel during movement and activity reflects how sensitive the structures are – not how injured you are. It is safe and normal to feel some pain when you start exercising. This usually becomes less painful as you become more active and accustomed to the movements. Exercise and movement are actually one of the most effective methods for getting rid of back pain!

6. Back pain is NOT caused by poor posture.

How we sit, stand or bend does not cause back pain, although these movements can be painful. A variation in posture is good and healthy for the back. It is safe to relax your back muscles during everyday activities such as sitting, bending or lifting with a curved back. In fact, it turns out to be more effective!

7. Back pain is NOT caused by weak a core.

A weak core do not cause back pain! People with back pain often tighten the core muscles excessively as a preventative response. This is like clenching your fist after spraining your wrist. Being strong is important when you need the muscles to be activated, but being overactive all the time is not helpful. Learning to relax your core during normal daily activities can be valuable (For example, when you cook, wash the house or relax on the sofa).

8. The back does not get worn out with daily strain and bending.

In the same way that weightlifting makes us stronger, movement and load make the back stronger and healthier. Activities such as running, rotation, bending and lifting are completely safe if you start gradually and do it regularly.

9. Pain flaring does NOT mean that you are hurting yourself. 

Pain flaring can be painful and scary, but are rarely related to tissue damage. Common triggers can be poor sleep, stress, tension, restlessness, depression, inactivity or unfamiliar activity. Controlling these factors can prevent worsening of the pain. If you have a pain flaring, you may want to stay calm, relax and keep moving, instead of treating it as an injury.

10. Injections, surgery and strong medicines are usually not a good solution.

Injections, surgery and strong medicines, such as opioids, are not very effective for prolonged back pain. This type of measure comes with risk and can have very unfavorable side effects. The key to a healthy back lies in finding low-risk methods to control the pain.

Summary:

The back is robust! The back can withstand a lot! The back is made for movement and load! Despite what we know about back pain, it’s a major problem in today’s society. Many people still live to this day in the belief that the back is fragile and very prone to both disc slips and misalignments. This mindset may be a bigger contributor to the problem than we previously thought. Although our knowledge of back pain is a lot higher today than just ten years ago, one should not neglect or avoid taking the back patient seriously. The pain is real and it is important to see the patient as a whole. On the plus side, there is rarely any serious tissue damage and the road to a less painful back may be shorter than you think. If you experience prolonged back pain and are worried about what it may be, it is a good idea to seek out a therapist who can examine, treat, soothe and guide you in the process.

I hope this has been interesting reading and that you have learned something new. Whether you are struggling with back pain yourself or if you know someone who does.

Stay active, use your back and make it bulletproof for the future!

Erik R. Kløvstad

Physiotherapist