Dr. Elliott Perkins
10 Facts About Low Back Pain
This blog post is based on the article titled “Back to basics: 10 facts every person should know about back pain” published in the British Journal of Sports Medicine. For access to the full article, click here:
1. Persistent low back pain can be severe and scary, but it’s rarely dangerous
Less than 1% of cases of low back pain are caused by serious stuff. The odds are very much in your favour that you will recover fully and get back to normal in time.
2. Getting older is not a cause of low back pain.
Low back pain is not caused by ‘wear and tear’ and the rates of low back pain do not increase as people age. Also, exercise is just as effective for the management of low back pain in 80-year-olds as It is in 20-year-olds!
3. Persistent low back pain is rarely associated with severe tissue damage.
Our spines are very tough, and it takes a lot to injure them. Often people have back pain with everyday movements, without any injuries at all. For those individuals who did suffer an injury to their back, it will typically heal in a matter of weeks. When people have back pain lasting longer then this, there are often other things going on that makes them more sensitive to pain. Things like, stress, fatigue, inactivity, and new activities that the body isn’t accustomed to. None of these are dangerous and can all be improved!
4. Xrays, MRIs and CT scans rarely show the cause of back pain.
Sometimes, we do need to take a scan, but this Is for a minority of people, the people we think something serious might be going on. There are a lot of very common things seen on scans that sound scary, things like disc bulges, degeneration, arthritis, etc. But! Even people who don’t have low back pain also have these findings! So what gives? These things we find on scans are called ‘incidental findings’, meaning they are there, but they aren’t the cause of your pain and they do not predict future pain or disability.
5. Just because exercise or movements hurt doesn’t mean you are doing harm.
When you have low back pain its normal for your spine and spinal muscles to become very sensitive to movement and to touch. This pain represents how sensitive your back is, NOT how damaged your back is. It is safe and normal to feel some pain with exercise and movement, but we know that the more you do, the less sensitive you become. This is an important step on the road to recovery, because exercise is one of the most effective ways to treat low back pain. If you are worried then have a professional coach you through exercises in a comfortable way.
6. Back pain is NOT caused by poor posture.
The ways that we sit, stand, walk and bend over has never been shown in research to cause low back pain. It Is safe to change our posture regularly, and to relax when we sit, stand and even lift.
7. Back pain is not caused by a ‘weak core’.
In fact, people who have low back pain tend to tense their core muscles as a form of muscle guarding. Having muscles on all the time and tense all the time isn’t helpful. Imagine clenching your fist after spraining your wrist! Ouch!
8. Our backs don’t ‘wear out’ with lifting and bending.
When we lift weights, our muscles get stronger. Similarly, when we regularly lift, bend and move our spines they get stronger too. The more you move the healthier your back will become. If your back hurts with movement, that’s ok! As we mentioned earlier, its not dangerous. Start low, go slow, and do a little bit more every day. With time your back will get stronger and less sensitive.
9. Low back pain ‘flare ups’ are not dangerous.
It is normal for people to experience repeated bouts of low back pain throughout their life. If you are experiencing a ‘flare up’ of your back pain, don’t worry! It is not because you damaged it. It is often related to stress, poor sleep, or maybe a little bit too much of an activity you weren’t accustomed to. It got better last time, it will get better this time with time, exercise, and help from a professional if you think it will help.
10. Injections, surgery and strong drugs are most likely not the cure.
In most cases, injections, surgeries and opioids don’t work very well in the long term, and they come with a number of inherent risks. There are many low-risk ways to control your low back pain that are even more effective!
My goal is to help you make sense of your pain condition, coach you in skills that will help you gain control of your pain and teach you lifestyle strategies to help you self-manage. If you have any questions at all, you can contact me anytime.