8 Myths about back pain
Rosemary Marchese – Physiotherapist and Certified Schroth Physiotherapist for Scoliosis
Back pain can be caused by one or more of a large number of factors. Risk factors for back pain can be different even between two family members. What we do know is that once you have had back pain once, you are more likely to experience it again. Approximately eighty percent of the population is likely to experience at least one episode of back pain at least once in their life. Along the way as a physiotherapist I hear myths about back pain on a frequent basis. In a previous blog about back pain I highlighted some of the more common causes of back pain. Now it’s time to get the myths better understood.
Myth 1: Back pain always means the back is damaged
While back pain can be caused by many factors, it is not always caused by permanent damage. Of course, there are exceptions to the rule, for example a fracture that causes a slippage can cause pain, and there may be long term pain associated with that. On the flip side of this many people have had a fractured spine but do not necessarily experience long term pain or problems.
Myth 2: Back means your back is ‘out of place’
I hear this all the time! ‘I was told my back is out’ or ‘My hips are out’. It’s at this point in time I want to ask people ‘Where do you think it went?’
It’s almost impossible to find a person is ALWAYS perfectly aligned and even many of us that are not in ‘textbook alignment’ do not have pain. Why? After my training in scoliosis and sagittal deformities such as Scheurmann’s disease, I am finding that some of the skills and knowledge I implement for these patients can often be often be useful for my non-curvy patients. You see, some people have a ‘flat back’, but if that matches well with their pelvic parameters (angles) then these people can often have a ‘harmonious’ back, and may rarely suffer from back pain. If their flat back doesn’t really match their pelvic orientation then some parts of the back, such as the discs may suffer. While I might describe this as the back and pelvis not really being perfectly matched, or being a little ‘disharmonious’, I find that using the terms ‘out of place’ really scares people unnecessarily. I often find these people have a history of back pain and seeing health practitioners for years and years, without their true issues ever really being truly addressed.
Myth 3: The back is extremely delicate
While the back is made up of many delicate structures, it is well designed to move and carry load. Of course, it needs a rest from time to time, but overall the back is well designed to be supported by ligaments and muscles. It’s up to you to find out how to properly strengthen your back in a way that suits YOUR back. No two people are the same!
Myth 4: Back pain always runs in families
I’ve seen back problems that tend to run in families and others that don’t. Some conditions, such as Ankylosing Spondylitis, Scheurmann’s and Scoliosis, can run in families, but this is not always a strict rule. Even then the pain levels in one family member may not mimic the pain levels of another family member with the same condition. I have seen back pain in one twin but not the other. Just because your parents had back pain doesn’t mean you will. However, it is still wise to try to find out your family history to make sure you are informed, and if necessary, carry out necessary precautions to avoid problems, if possible.
Myth 5: Back pain should always be diagnosed with an MRI
MRIs can be very useful tools for some people with back pain, but many people who insist on having an MRI are often disappointed to find out it doesn’t marry up with their pain levels. Also just because you ‘find’ something on MRI, such as slight bulging disc, this does not necessarily mean that is the cause of your pain. Be guided by your physiotherapist or specialist in this area.
Myth 6: Nothing on a scan means your back pain is ‘in your head’
No! Actually, I get frustrated with this when people are suffering from back pain and previous treating practitioners have ‘found nothing’ on MRIs or CTs or X-rays to justify the pain being reported. Pain is the sum of a multitude of factors and not all of them can be explained by scans.
Myth 7: Rest is the best cure for back pain
Bed rest used to be a commonly prescribed treatment for back pain. We now know that this can often make matters worse. The plan of action for back pain needs to be individualised. Prolonged bed rest weakens muscles and surrounding structures, thus making the back less strong and more predisposed to further problems.
Myth 8: Medication is best for back pain
I can’t tell you how many people I have seen on a list of drugs that scare me! I like to work closely with the prescribing doctor to see if there is anything we can do to get people to
stop using medications for back pain relief. During this time it is my job to get people independent again with a ‘can-do’ attitude and individualised strategies that suit their back!