There are many, many myths around back pain. And today, I will share the six most common myths that I have found in my experience as a Physical Therapist.
Research Surrounding Back Pain
The great thing about back pain is that there is a lot of research done in this area. It can be frustrating as a patient because you may have been told certain things about your back pain, so when the research becomes updated, it can seem like health practitioners told you the wrong things to take care of your back pain. However, know that healthcare practitioners are doing the best they can with the knowledge they have at a given time. That is why it is important to find a health care provider who is consistently updating their knowledge with new clinical guidelines based on evidence and clinical experience. As you read this blog post today, some of these myths may be confusing as it is something that was considered the gold standard for treatment of back pain before. If you have questions around any of these myths, feel free to email hello@brightheartyogastudio.com so that we can further help you understand the research that is now supporting care of back pain.
The Myths
Myth 1: Having A Weak Core Causes You To Have A Back Pain
This is a common myth that I used to tell my patients all the time. I thought by strengthening core muscles, pain would completely go away. And as it turns out, pain is a little more complex than that.
When I was in physical therapy school, we learned about the muscle called transverse abdominis as the holy grail muscle that “turns off” when back pain is present. However, more updated research is showing us that transverse abdominus does not necessarily turn off when an episode of back pain begins.
Now, does this mean I throw out strengthening of the abdominal muscles? Nope! What we do know about the nervous system is that if we can do movements that can make it feel safe, back pain becomes less. By doing activities to involve the abdominal muscles, this helps to shift the nervous system’s attention away from your back. This is more likely what helps to decrease back pain.
Myth 2: You Need An MRI To Determine Why You Have Back Pain
Different research studies concluded that imaging does not correlate to the severity of the back pain. Sometimes, the imaging looks completely normal, meaning a herniated disks or decreased space in the spinal canal doesn’t show up in the MRI, and a person may still be experiencing back pain.
The MRI image, while it may give you a picture of what is happening inside your spine, it does not give us the best next steps for Physical Therapy. As a PT, I look at the person in front of me and figure out what their goals are and then treat them based on that. When it comes to back pain, we rarely treat based on the diagnosis, we treat based on the functional impairments you have.
If conservative treatment has failed, then a MRI may be warranted. This can help to determine best next steps in receiving an injection or surgery.
Myth 3: I Have Back Pain Because My Spine Is Out Of Alignment
The spine is really sturdy and you have ligaments on the front and the back side of your spine that help hold it in place. You also have ligaments for each vertebrae so it further helps to support the spine.
So, seems out of alignment, it is more likely to be a muscle imbalance where one side might be tighter or stronger than the other. So, it could look like you are leaning more towards one direction, but in actuality it has something to do more with the dominance of muscles.
Unless you had a traumatic accident, like a car crash or falling from somewhere, your spine is not out of alignment and it is not what is causing your back pain.
Myth 4: Degeneration Of Your Spine Causes Back Pain
As we age, it is very normal to have degeneration. Degeneration is when the vertebral disks between each vertebrae in your spine is losing its height. You may notice that you lose an inch or so in height as you get older. It does seem like a scary term so I get why it is mistakenly related to back pain.
We see back pain tend to be more in the age groups of 30 to 50 rather than ages older than that. We do not see significant degeneration changes until we are over the age of 50. It doesn’t really add up that spinal degeneration is causing your back pain based on these statistics.
Myth 5: Poor Posture
Many people are concerned about their posture, particularly in their lower back, that is either over rounding or extended. Pain tends to occur when we are in a sustained posture for a longer period of time, like sitting when you are working. When you sustain a position for an extended period there is lack of blood flow and this disrupts the nervous system. It sets off an alarm to the nervous system that makes your brain perceive danger, in turn causing pain.
You do not have to be so concerned about having the perfect posture because you have to be more concerned about moving throughout the day and getting in breaks when you have been sitting or standing for a long period of time.
Myth 6: When You Have Back Pain, You Need To Rest And Not Move
When you have pain, the initial response may be to not move because you do not want to feel worse. Realistically, the more that you do not move, it trains our nervous system and our muscles to guard more when you move, and this results in the continuation of the pain cycle.
It is important to note that you do not need to move the same way you did before you felt the pain. Gentle movements are preferred when this happens, so that your body and your brain knows you are safe doing such activities. Later on, you can increase the types of activities you are doing.
One of the movements I advise my patients to do when they have consistent lower back pain is a walking program. It is gentle and will not perpetuate the pain cycle. You will increase walking and other exercises over time to help the nervous system know that it is safe when it is exercising and doing motions.
Final thoughts
I would like to reiterate that your healthcare provider was not necessarily wrong in sharing the above myths with you, as it may be the knowledge they had available to them at the time. Most healthcare providers strive to learn more and may change their treatments over time based on this new knowledge. Remember to ask questions if you aren’t sure about something and to make sure you are getting the best treatment possible from your healthcare team. Need help with back pain? Sign up for a free 15 minute consult with me to see if I can help you!