Lower back pain is one of the most common presentations seen by physiotherapists. Ranging from small aches, to seemingly completely debilitating spasms and ‘locking up’, there is a variety of severity with which back pain can occur.
While initially it can be very worrying, improved understanding of the causes and approaches to treatment can have a beneficial impact on recovery and prevention of acute back pain. Identified below are some common myths about back pain that are inaccurate, misleading, or even counterproductive.
Myth #1 – Discs can ‘slip’ out of place
Between each vertebra of the spine, there are discs made of fibrocartilage which assist in providing flexibility and shock absorption in the back. Historically, many health professionals including doctors and physiotherapists have told patients that one or multiple of these discs had ‘slipped’ as a way of explaining their pain to them. While it provided a diagnosis to explain the pain, this is not entirely accurate. Vertebral discs are very strongly secured to the vertebra above and below, and rarely, if ever 'slip' out of place.
Discs may bulge slightly or in some cases tear, which can contribute to pain in the lower back, however very commonly these injuries will heal without any permanent damage. In fact, most people will have a minor disc bulge to some degree without causing any pain at all. The understanding that your spine is disfigured, as a part has permanently ‘slipped’ out of place, can cause you to move differently and be over-protective, which in turn can create further dysfunction and pain.
Myth #2 – If you have lower back pain, you should stay in bed
Following the onset of back pain, a commonly used strategy is to rest, avoid movement and wait for the pain to subside. However, studies have shown that remaining active and performing targeted and gentle exercises can help to improve low back pain. While you may not be able to do everything you normally would, it is important to continue with as much of your usual day to day activities as possible. The desire to stop moving and ‘protect’ the spine can ultimately result in increased amounts of stress and abnormal movement patterns. These chances can lead to an ongoing experience of pain, even after the original injury has healed. If you are unsure of what amount of activity you can be doing, or which exercises are best to help, your physiotherapist can assist you with a targeted exercise program.
Myth #3 – Severe pain means severe damage
Severe pain with a sudden onset and without warning can be a very intimidating experience. Typically, we tend to associate large amounts of pain with serious injury, so it’s not unusual to assume that you have sustained a large amount of tissue damage.
Luckily, in most cases this is untrue. As the spine is surrounded by nerves, it is a particularly sensitive area of the body, and therefore can produce strong pain signals even without significant damage. Due to this, a small ligament strain or minor muscle tear can be responsible for causing a large amount of pain compared to if these injuries were to occur in a different part of the body. The positive aspect of this is that it’s common for intense symptoms to settle relatively quickly, even resolving themselves within a few days.
In many cases, symptoms that are present for longer than a 2-3 week period after the initial injury are typically caused by changes to your movement patterns. These changes tend to occur in response to pain and the body trying to protect the sore area, even though the original injury has healed.
If you are experiencing back pain, the best person to see is your physiotherapist. They can assist you with your recovery, helping to avoid any unwanted complications or side effects. They can also rule out any serious damage which may warrant further investigation, and help you gradually return to your normal lifestyle.