Unfortunately, back pain is incredibly common with the National Institute of Clinical Excellence estimating up to 60% of us can expect to experience it at some point in our lives.
In the last two decades, our understanding of the causes, triggers, and best treatment methods for back pain has undergone significant changes. The traditional notions of avoiding lifting heavy objects without proper form and resorting to surgical treatment for chronic low back pain are no longer considered valid.
With so much conflicting information available, it can be hard to know what to do when you are dealing with back pain. This article aims to clear up some of the most widespread misconceptions about back pain and provide accurate information.
“BED REST WILL HELP EASE MY BACK PAIN”
It is a common misconception that when experiencing back pain, you should avoid physical activity and rest as much as possible. In reality, research shows that staying active and engaging in movement can lead to significant improvements in pain, quality of life, and functional mobility. While it is important to avoid over-exerting yourself, small activities such as walking, swimming, cycling or specific exercises to improve spinal mobility and connective tissue health can help to reduce recovery time. On the other hand, prolonged bed rest is not recommended as it can lead to persistent pain and negatively impact mental health and overall quality of life.
“I CAN’T DO EXERCISE WHILST I HAVE BACK PAIN, ESPECIALLY WEIGHT TRAINING!”
Exercise is widely recognised by healthcare professionals as the most effective method of managing low back pain, whether it is acute (i.e. lasts a few days or weeks) or chronic (i.e. pain that lasts for 3 months or longer). Many studies have demonstrated that weight and high-load resistance training can greatly benefit individuals suffering from low back pain. A study published in 2014 found that stability exercises have a significant positive impact on long-term outcomes related to pain and disability. Similarly, research by Searle et al. (2015) found that strength/resistance and coordination/stabilisation exercise programs can have a considerable positive impact on individuals with chronic low back pain.
Studies have shown that no one type of exercise is superior to another. Therefore, if you find an exercise class or sport that you enjoy, stick with it and gradually increase the intensity as your fitness improves. Such activities not only can be beneficial for reducing back pain but also for overall health. Combining exercises with therapies such as osteopathy has also been found to have even greater benefits than using only one of these methods. Osteopaths have a deep understanding of the causes of stress on the body and can incorporate specific stability and mobility exercises into their treatment plans, helping patients take control of their pain and achieve a pain-free life.
“I MUST GET A SCAN TO FIND THE CAUSE OF MY BACK PAIN!”
Recent years have seen a growing body of evidence that suggests that scans like MRI’s and X-rays are not very effective at identifying the specific structures that may be causing back pain. Not only do the results of these scans often not align with the symptoms being experienced, but many people without back pain may have similar scan results. A study from 2015 showed that a high percentage of asymptomatic individuals, particularly those who are older, have imaging findings of spinal degeneration, which is now considered a normal part of ageing and unlikely to be associated with pain.
A study published in 2018 found that even among healthy individuals without a history of back pain, a significant number (23.4%) showed positive MRI results for sacroiliac irritation or inflammation, while only 6.4% of patients suffering from chronic low back pain had this finding. This indicates that those individuals with symptoms actually had fewer abnormalities on MRI scans than those without symptoms.
These findings and others like them demonstrate that scans and imaging alone cannot provide a definitive explanation for why someone is experiencing pain. While MRI scans can be useful in certain situations, such as when a clinician suspects a fracture or infection, they are not always reliable in identifying the source of pain. Additionally, there is evidence to suggest that having a scan can actually exacerbate the situation for patients, especially when the report uses technical language such as “stenosis of the intervertebral foramina” or “degeneration of the vertebral end plates,” which do not necessarily indicate pain and are considered normal consequences of ageing.
“IF I HAVE PAIN, THAT MEANS I’VE DAMAGED MY BACK!”
Contrary to popular belief, the level of pain you experience is not always directly proportional to the amount of physical damage that has occurred. Pain is a complex phenomenon that arises from a variety of factors including physical damage, stress, mental health, beliefs, past experiences of back pain, and the environment.
What is pain? Pain is a sensation, just like touch. Pain is an emotion, just like anger. Pain is a behaviour changer, just like hunger. Basically…it’s complex. But it’s not just a symptom or sign of damage. It’s more a perception of threat and when perceptions of threat are changed, feelings of pain are changed. Pain. Change the meaning. Change the feeling.
How Can Osteopathy Help?
As osteopaths, we take a holistic approach to healthcare that focuses on the diagnosis, treatment, and prevention of a wide range of musculoskeletal conditions. Our approach is based on the principle that the well-being of an individual depends on the joints, muscles, ligaments, and connective tissues functioning smoothly together. Osteopathy is a manual therapy that addresses the root cause of pain and dysfunction in the body.
During your initial appointment, we will gather information about your symptoms, relevant health and medical history, how back pain is impacting your daily activities and consider any ergonomic or environmental factors. We will then conduct an osteopathic examination which may involve a series of movement tests to see if the pain is restricting your range of movement.
When it comes to treating back pain, osteopaths use a variety of techniques to help alleviate pain and improve function. These may include physical manipulation of the spine and other joints, mobilisation, stretching, soft tissue massage, and exercises to improve strength and flexibility. Osteopaths work closely with their patients to identify any underlying causes of the pain and address them through lifestyle changes and advice.
Want to hear how we have helped many others who once suffered from back pain? Read our 99+ Google reviews! Book online here or call 01277 676 676 to schedule an appointment with our osteopaths at Body Beliefs, who are ready to help you manage your back pain!
SOURCES:
Bevan, S. (2015). Economic impact of musculoskeletal disorders (MSDs) on work in Europe. Best Practice & Research Clinical Rheumatology, 29(3), 356-373.
De Winter, J., de Hooge, M., van de Sande, M., de Jong, H., van Hoeven, L., de Koning, A., … & Weel, A. (2018). Magnetic resonance imaging of the sacroiliac joints indicating sacroiliitis according to the assessment of Spondyloarthritis International Society definition in healthy individuals, runners, and women with postpartum back pain. Arthritis & rheumatology (Hoboken, NJ), 70(7), 1042.
Videman et al, (2003) Associations Between Back Pain History and Lumbar MRI Findings
Webster et al, (2010) Relationship of early magnetic resonance imaging for work-related acute low back pain with disability and medical utilization outcomes.
Baker, A. D. (2014). Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. In Classic papers in orthopaedics (pp. 245-247). Springer, London.
Arnbak, B., Grethe Jurik, A., Hørslev‐Petersen, K., Hendricks, O., Hermansen, L. T., Loft, A. G., … & Holst, R. (2016). Associations between spondyloarthritis features and magnetic resonance imaging findings: a cross‐sectional analysis of 1,020 patients with persistent low back pain. Arthritis & Rheumatology, 68(4), 892-900.
Schmidt, C. (2017). Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. manuelletherapie, 21(02), 54-55.
Brinjikji, W., Luetmer, P. H., Comstock, B., Bresnahan, B. W., Chen, L. E., Deyo, R. A., … & Wald, J. T. (2015). Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. American Journal of Neuroradiology, 36(4), 811-816.
Berg, L., Hellum, C., Gjertsen, Ø., Neckelmann, G., Johnsen, L. G., Storheim, K., … & Norwegian Spine Study Group. (2013). Do more MRI findings imply worse disability or more intense low back pain? A cross-sectional study of candidates for lumbar disc prosthesis. Skeletal radiology, 42(11), 1593-1602.
