Low Back Pain Misconceptions

Whenever a topic receives a large amount of attention, the good, bad, and ugly are all spewed into mainstream media. This often leaves the consumer lost and confused regarding the truth. Many misconceptions exist surrounding the causes of back pain and best treatment options. 

Misconception 1: The best treatment for low back pain is rest

When on bedrest, muscles atrophy at a rapid rate. Within 1 week of bedrest, the body loses 12% of it's muscle mass. At 3-5 weeks, the muscles atrophy over 50%. After a low back injury, it is necessary to get the spine moving to prevent muscle wasting, improve lymphatic drainage, and increase blood flow to the injured region. While rest is not the best solution, it should be known that if you are experiencing acute low back pain, excessive exercise can also prolong your recovery. My recommendation: graded, protective exercise. Perform gentle, non-threatening movements for the spine. Additionally, exercises like the recumbent bike or walking in a pool are excellent. Ultimately, let pain be your guide.

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Misconception 2: Back pain is pathological

Pathology is defined as the causes and effects of a disease. Back pain is not a pathology. It is merely a symptom. In fact in many instances the cause of low back pain is not the low back. Low back pain manifests because the areas surrounding the low back- primarily the hips and middle back- are stiff and tight. The low back is forced to take on extra stress thus becoming injured.

Misconception 3: Back pain means the back is weak

With low back pain, there is a tendency to believe that the spine is weak, fragile, or frail. These thought viruses keep people from returning to normal activities because of the fear that the low back is not stable. In reality, the low back is often very strong. The spine is meant to absorb large compressive forces. It will not break simply because you are now experiencing pain. Think strong! 

Misconception 4: Back pain is a normal part of aging

Back pain occurs because of a loss of stability or mobility somewhere in body. In general older people experience pain because they stop using certain muscle groups. For example, think about the last time your father (or grandfather) jumped? Or the last time he performed quick side-stepping movements as an exercise. Younger individuals naturally perform these movements when playing sports or running around with their friends. Older people simply avoid these activities and the result is pain.

Misconception 5: ​Disc herniations are the cause of my pain

While traumatic disc herniations can be the source of pain, many times a disc herniation is not the cause of one's pain. A 2014 study, found that >50% of individuals from 30-39 years old without low back pain had degenerative changes and bulging discs. The participants in the study were completely asymptomatic young people, yet still demonstrated some spinal changes! Disc herniations should be thought of as ‘internal gray hairs.’ Just as our body ages on the outside, it also ages internally. The internal aging process is natural and not the source of our pain

Considering disc surgery? Get a second opinion! A 2011 study was published evaluating the outcomes of individuals who had surgery vs. conservative therapy for disc herniations. While pain was reduced earlier in the surgical population, at 1-2 years of follow-up the outcomes were the same. 

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