Myths VS Facts Surrounding Lower Back Pain 

Written By T3 Physiotherapy
 

Lower Back Pain: An Overview

Current evidence from the Royal Australian College of General Practitioners (RACGP) show that lower back pain is the most common musculoskeletal complaint presenting to primary healthcare providers, affecting between 1 in 4 to 1 in 7 Australians. Lower back pain is frequently benign and self-limiting; however, a significant proportion of adults with acute lower back pain (10–40%) develop persistent and disabling symptoms. Hence, seeking treatment is essential to receive education and self management strategies to prevent ongoing symptoms.

Myth One - Lifting with “poor posture” is going to damage my back.

Backs are one of the strongest structures within the human body and while they are home to important structures such as the spinal cord, they are definitely not the delicate and fragile structures portrayed to the population from childhood. Often we are given the analogy of the jam donut to describe our spinals discs however, this couldn’t be further from the truth - car tyres is the more appropriate analogy. Point being - they’re strong, sturdy and resilient!

We are often taught from an early age that we must protect our backs by lifting with bent knees and a straight back however this is NOT true. There is no evidence in the scientific literature that supports this claim and it actually influences our beliefs negatively which can heighten the sensitivity and anxiety and we experience with back pain.

 

Myth Two - My discs are bulging, my disc fibres are torn, my back is broken!

It is part of the ageing process to see bulging discs, annular fissures and a variety of other normal changes in the scans of our back - none of which correlate to pain! Recent studies show a large cohort of asymptomatic people with ‘degenerative spinal findings’ demonstrating that we need to assess other areas of our patients to determine what is contributing to their pain experience.

“If there’s nothing wrong with my back, well then, what is causing the pain?!” Pain is a very complex experience we endure and is unique to each individual. Stress, sleep, beliefs surrounding pain and a variety of other factors contribute to how we experience pain. Pain is an evolutionary mechanism to protect us from potential damage…

 

Myth Three - I need bed rest to treat my back pain!

Bed rest can be highly problematic for individuals experiencing back pain because it heightens our beliefs that pain controls our lives and is important enough to stop us from participating in our normal activities. Instead we need to ‘re-teach’ our backs that movement is not only safe but essential to lower the sensitivity of our backs and reduce the pain we experience. Simple and enjoyable activities should be commenced to achieve this, such as; walking, gentle yoga, hydrotherapy etc.

T3 Physiotherapy always advises those experiencing back pain to seek a medical professional to rule out potentially sinister, yet rare pathologies.

References:

  1. Almeida M, Saragiotto, Richards B, Maher C. Primary care management of non-specific low back pain: key messages from recent clinical guidelines. Med J Aust 2018; 208 (6): 272-275

  2. Ford J, Hahne A, Surkitt L, Chan A, Richards M. The Evolving Case Supporting Individualised Physiotherapy for Low Back Pain. Journal of clinical medicine. 2019 Sep;8(9):1334.

  3. Foster N.E, Hill J.C, O'Sullivan P, Childs J.D, Hancock M.J. Stratified models of care for low back pain. WCPT Congress, Singapore, 2015

  4. Henschke N, Maher CG, Refshauge KM, et al. Prevalence of and screening for serious spinal pathology in patients presenting to primary care settings with acute low back pain. Arthritis Rheum 2009;60:3072–80.

  5. Hill JC, Whitehurst DG, Lewis M, Bryan S, Dunn KM, Foster NE, Konstantinou K, Main CJ, Mason E, Somerville S, Sowden G, Vohora K, Hay EM. Comparison of stratified primary care management for low back pain with current best practice (STarT Back): a randomised controlled trial. Lancet 2011;378:1560-71.

  6. Kjaer P, Kongsted A, Ris I, Abbott A, Rasmussen CD, Roos EM, Skou ST, Andersen TE, Hartvigsen J. GLA: D® Back group-based patient education integrated with exercises to support self-management of back pain-development, theories and scientific evidence. BMC musculoskeletal disorders. 2018 Dec 1;19(1):418.

  7. Koes BW, van Tulder M, Lin C-WC, Macedo LG, McAuley J, Maher C. An updated overview of clinical guidelines for the management of non-specific low back pain in primary care. Eur Spine J 2010;19:2075–94

  8. M.Hancock. Approach to low back pain. RACGP, 2014, 43(3):117-118

  9. O'Sullivan, P. and Lin, I. Acute low back pain Beyond drug therapies. Pain Management Today, 2014, 1(1):8-14

  10. Wheeler, L. P., Karran, E. L., & Harvie, D. S. (2018). Low back pain: Can we mitigate the inadvertent psycho-behavioural harms of spinal imaging?. Australian journal of general practice, 47(9), 614–617. https://doi.org/10.31128/AJGP-03-18-4525

T3 Physiotherapy https://www.t3physiotherapy.com
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