Back Pain

Uncategorized Aug 08, 2020

Back pain is extremely common. In fact, about 84% of people worldwide will experience back pain at some point in their lives. Given the prevalence of back pain, we thought it would be good to talk about some of the common myths we hear and give some tips about managing and preventing back pain.

 

Q. Lifting heavy weights, especially with a bent back is bad.
A. Just like lifting weights makes muscles stronger, lifting weights makes the
back stronger and more resilient. Of course, lifting something awkwardly or a
load you are unaccustomed too can be a factor that contributes to pain, just
like any other part of your body. However, we know that an appropriate
resistance training program that starts with manageable loads and builds up
slowly is safe and beneficial. Research has also not demonstrated an
associating between lifting with a bent back and pain. The human body is
very adaptable and as long as you start low and go slow, it is very unlikely
that you will injury yourself.

 

Q. That’s fine, but I know I have a bad back. I have had an MRI that showed I had lots of things wrong with my back.
A. Scans are only useful in the very small minority of people where there is a
suspected fracture, cancer or infection. Scans will almost always show things
like disc bulges, joint degeneration, stenosis and arthritis. Unfortunately, the
report doesn’t tell you how common these findings are in people without
pain and that they don’t predict how much pain you experience. The
prevalence of these findings increases with age, so you can think of them
more like wrinkles than injuries. Scans can also change over time – most disc
prolapses shrink, and the worse the prolapse the more likely it is to do so.

 

Q. Someone I know had back pain, they saw a surgeon and ended up needing an operation.
A. Surgery is rarely an option for back pain. We used to think that if we could
operate and take out the structure causing pain, we could solve someone’s
back symptoms. We now know that pain is the result of lots of different
factors and often removing a structure has no effect on pain. Surgery is also
very expensive and costly. Of course, in a very small minority of cases it can
be useful, but we know the best way to improve back pain is keeping active
and understanding that the pain is highly unlikely the result of something
serious.

 

Q. I’m worried my back pain will get worse as I get older.
A. There is no evidence to suggest that getting older causes or worsens back pain. In fact, stopping or avoiding activities because of fear may leave you less prepared to handle those tasks – meaning you are more likely to experience pain when you have to perform such an activity.

 

Q. I have terrible posture – that’s why I get back pain.
A. There is no one CORRECT way to sit, stand or lift, even though sometimes these activities can be painful. Rather than restricting yourself to sitting up perfectly straight try relaxing, and regularly changing your position. Being relaxed during everyday activities is far more important than being in any one position. The same goes for everyday lifting – lifting with a rounded back is actually more efficient!

 

Q. The reason I have back pain is my weak ‘core’.
A. The word ‘core’ implies a particular set of muscles that are more important than others and it is often thrown around when people talk about back pain. In fact, we have a very hard time defining, let alone measuring how strong these muscles are. Having weak ‘core’ or trunk muscles does not cause back pain. People with back pain often tense their trunk muscles in a bid to keep their back straight and stiff whenever they bend over. This is unhelpful. We need to learn to trust our backs and move in a relaxed way.

 

Q. What is the best treatment for back pain?
A. Whenever you have an episode of back pain, you may feel as though you should rest, especially during the first couple of days where you are particularly sensitive to movement and it seems like everything is painful. However, we know that bed rest can increase the likelihood that back pain persists, so here are some evidence-based tips for managing your back pain and reducing the risk of recurrence:

  1. Keep Active! – Rest will nearly always make things feel better, but it’s important that you keep moving, even if it is a gentle walk. Over time it’s important to slowly reintroduce exercise and movement that you are used to and enjoy. Remember that pain with movement DOES NOT mean you are doing harm.
  2. Educate yourself on Pain and understand that back pain is very rarely associated with serious damage. Tissue healing occurs within 3 months, so if pain persists past this time, it’s usually the result of other factors. This video by Pain Scientist Lorimer Moseley is a good place to start in understanding your pain more. https://www.youtube.com/watch?v=ikUzvSph7Z4
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