The Nine Most Common Back Pain Myths

Posted on May 20, 2007 and filed under Neck and Back

Have you ever experienced backpain? Most of us have, and it can be excruciating. It is estimated that 80% of all people will suffer from back pain at some point in their lives. And back pain is the most common cause of loss of activity in adults and costs the economy billions of dollars in lost productivity each year. Even worse, people who do have back pain have an almost 80 percent chance of reinjuring their back if they don’t get proper care. Chances are, you’ve either suffered from back pain in the past…or will in the future. So listen carefully – this article is written for you. First I want to discuss what causes back pain and where it occurs most frequently. The most common site of back pain is the lumbar region of the back. In layman’s terms, the lower back. The reason back pain pops up here so frequently is because that area of your back – the lumber spinal region - absorbs many types of forces every day. These forces include bending, sitting, coughing (believe it or not), stooping and lifting. The cause of lower back pain is degenerative changes over time to the lumbar discs. Here’s an easy way of visualizing what happens. Think of your spinal discs as jelly doughnuts. They have a soft, jellylike center as well as a firm fibrous outside covering that houses the jelly part of the disc. The outside fibers are oriented around the nucleus of the disc (the jellylike part) and resist twisting movements of the spine. The center - or jellylike portion of the disc - is oriented vertically to resist compressive forces. Roughly 80 percent of your discs are composed of water which makes the center pliable and provides cushioning. However, as we age, that jellylike material dries out, shrinks, loses its elasticity and becomes more brittle. What happens next is a progressive weakening of the tissue an a slow break down. Then, through the stresses of everyday life - coughing, sitting improperly, etc. - your disc can bulge, and in some cases, actually rupture and spill some of the soft jellylike material into the surrounding space. Ouch! Also, the fibrous outside covering of the disc can tear. If it tears, it creates inflammation around the disc. This swelling can irritate your nerve roots, nerve endings and the blood vessels around your disc and vertebrae. Numbness, tingling, muscle spasms and pain can be the result. That’s what happens over time. However, back pain can also be caused by a more traumatic event such as bending the wrong way, experiencing an auto accident or lifting improperly. If you’ve ever felt that type of sharp, instantaneous pain you’ll never forget it. It’s literally the straw that breaks the camel’s back. To avoid back pain before it happens - and treat the pain once it occurs - takes education and awareness. There is a whole variety of different back problems and treatment options that can be effective. In my opinion, however, the first step is clearing away a few myths and misconceptions regarding back pain. And that’s exactly what I want to do in the next portion of this article. So let’s go over the Nine Most Common Back Pain Myths And The Truth About Back Pain.

Myth #1: “It Won’t Happen To Me”

Reality: The fact is, about eight out of 10 people will experience back pain at some point in their lives. Back pain is the leading cause of disability in men over 40 years old. And it’s the second most common reason for a visit to a primary care doctor. Back pain is also the third most common reason for surgery and fifth most common reason for hospitalization. So unfortunately, most people do experience back pain…or will at some point in our lives.

Myth #2: “I’m Physically Active, I Shouldn’t Get Back Pain”

Reality: Being physically active is definitely a plus. And it’s true that well-conditioned individuals are less likely to experience back pain than sedentary people. However, back pain can affect all people regardless of their activity
level. In fact, runners are notorious for having back pain as a result of the forces and compression that take place during running. Golfers, people who play volleyball and people who engage in aerobics also experience back pain. So, whether you’re active or not, chances are you’re going to experience back pain at some point.

Myth #3: “The Pain Is So Bad There Must Be Ongoing Damage To My Back”

Reality: This is a tricky one. With acute pain, the level of pain usually correlates to the level of damage. In other words, the worse the pain, the worse the underlying damage. But you also have to take the length and the duration of your episode into account. For example, you may have severe back pain that subsides after a second or two. On
the other hand, with chronic back pain (any back pain greater than 4 - 6 weeks) the damage can be more severe. In this case, the pain does not necessarily correlate to the level of damage. So, just because you have back pain, it does not necessarily mean you have ongoing damage.

Experts say 80% of us will experience back pain at some point in our lives. And when it strikes - it can be excruciating!

Myth #4: “The Spine Is Fragile And Easily Damaged”

Reality: This is simply not true. Here’s the reality: you have 66 muscles that connect your lumbarsacral region. Combine that with the connecting tendons and ligaments and you have an incredibly strong and supportive structure for your spine. That entire “housing” is your primary support system for your entire body. It’s an incredibly well-designed and resilient structure. To help maintain your back and spine, you do need proper conditioning. This includes strength training, flexibility and aerobic conditioning (there are some exceptions to the rule, though. If you suffer from osteoporosis, have compression fractures or an unstable spinal fracture you should not engage in these activities). In general, however, your back typically does not need to be “overprotected” when recovering from an episode of back pain.

Myth #5: “Bed Rest Is The Secret To Recovering From Back Pain”

Reality: Actually, this is partially true. New studies reveal that it normally takes about three days of rest to recover from back pain. But 48 - 72 hours is all you need. Any more than that, and you’re making the problem worse. Here’s why: Too much rest can stiffen and weaken the muscles and joints..and in turn, increase the pain. If you read the April issue of this newsletter on Arthritis, you know that you should use your joints to reduce your pain and increase your mobility. It’s the same with back pain - you need to move. By the way, there are two reasons bed rest is recommended for back pain. First, to reduce the pressure on the disc and spine. Second, to stop any mechanical pressure that is irritating pain receptors. Any more than 48-72 hours can lead to more back pain in the long run.

Myth #6: “Heat And Massage Feel Good So They Must Be Helping Me”

Reality: Sorry. While these short-term remedies might feel good, they don’t provide a longterm solution. Of course, we do try to manage pain during recovery to allow patients to heal and get back to life, but heat and massage do not address the underlying causes of back pain.

Myth #7: “There Is A Standard Cure For Most Causes Of Back Pain”

Reality: Surprisingly, there is no “magic bullet” when it comes to back pain. In fact, compared to other medical conditions, there are very few standardized approaches. That’s why spine specialists such as physical therapists need to be consulted first - at the first sign of back pain. In addition, there are many different schools of thought in regards to treating back pain. Even different specialists within the same discipline may have different opinions. So, no, there really is no “standard cure.” That’s why it’s so critically important to see a specialist like a physical therapist and seek an individualized approach to your problem.

Myth #8: “Back Pain Means I’ll Need Surgery At Some Point”

Reality: Now here’s some good news. Just because you have back pain now does NOT mean you’ll need surgery in the future. Surgery is normally recommended when a diagnostic test reveals that the center of the disc — the jelly part –starts to rupture. Surgery is also required if you have an unstable fracture of the vertebrae. But surgery is always a last resort. Typically, a doctor or orthopedic surgeon will refer you to a physical therapist to see if they can take care of some of those symptoms first before resorting to surgery. If you do have chronic back pain, it could be also be arthritis caused by wear, tear and repetitive motion. An exercise program designed for strength and flexibility can help to strengthen your back muscles and avoid pain in the future.

Myth #9 “My Doctor Said I Need Surgery For My Back. Isn’t That Too Dangerous?”

Reality: Not true. People read things on the internet that cause them to forego surgery, or scare them into thinking that back surgery is incredibly painful. Again, assuming a test revealed no abnormalities, surgery is a last resort. However, surgery is only undertaken after physical therapy, rest and exercise is given ample time to work. Keep in mind that technology to predict and diagnose back problems is highly accurate now. Imaging systems such as CT scans and MRI scans create incredibly detailed pictures of your body which allows more precise methods of surgery. That means fewer complications than in the past, less risk and quicker recovery time.