Myth busting Chronic Low back pain

Back pain

Here we bust four myths or commonly held beliefs about persistent or chronic low back pain.

Myth 1: I need a scan to diagnose my back pain

Health care professionals are unlikely to refer you for a scan if your back pain is uncomplicated. This is because research shows that disc bulges and other findings such as osteoarthritis occur in people with no symptoms. In particular, they and actually become more common with age. If you have an MRI scan which shows a disc bulge, osteoarthritis etc., it doesn’t guarantee that this is causing your pain now. The chances are that you’ve had it for years.

Also, ‘non-specific’ lower back pain makes up 85% of all cases. This means they can’t attribute it to a cause i.e. a tumor, ‘pinched’ nerve, or infection. The best protocol to treat most types of back pain is to focus on controlling environmental and psychological contributors to your pain, symptom management, and a controlled and graded exposure to movement.

Myth 2: Pain is equal to damage

Modern pain science tells us that pain doesn’t always indicate damage. When it comes to back pain, it is normally a sign that a body part is sensitive rather than damaged. It is common for the muscles around your back to become sensitive when pain persists. Any pain on moving is normal and often decreases with more movement. Flare ups of back pain can be scary and disconcerting but they do not indicate damage. They are normally triggered and amplified by poor sleep, tension, stress, low mood, inactivity or unaccustomed activity. Controlling these things can help you avoid exacerbation of pain.

Myth 3: I should avoid exercise – especially weight lifting

Prolonged rest can actually lead to increased pain, poorer recovery and longer absences from work and sport. By not moving while experiencing back pain, you might create a ‘fear avoidance’ habit where your brain learns to avoid normal movements (like slouch sitting, bending and loading the spine)in fear of damaging your back. These beliefs are unhelpful and can contribute to further pain.  Aerobic exercise, improving lower back flexibility, and improve core stability have all been shown to reduce lower back pain. Research shows us that backs don’t wear out with lots of bending and lifting. When done in the right way, these movements can make our backs more resilient and healthy.

Myth 4: My disc has slipped

The spine is a strong stable structure that is not easily damaged. Thick ligaments make it near impossible for discs or any parts of your spine to slide out of place. Discs themselves are resilient structures too. Think of a tyre filled with chewing gum. Sometimes when a disc takes a large sudden force or lots of repetitive forces over time combined with age, the tough outer layer (annulus fibrosis) can tear and expose the central, more malleable substance (nucleus pulposus) forming a ‘disc bulge’. For some people this may be without symptoms, but for others it can cause extreme pain. This could be due to disc tissue aggravating  a spinal nerve or new research suggests that some people might be genetically more reactive when the nucleus pulposus is exposed. Importantly, research shows that disc related back pain has a good outlook for recovery, with some bulges being completely reabsorbed.


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