There is an overwhelming amount of information about back pain. To help you wade through the do’s and don’ts we are going to demystify the myths and put right some of the assumptions.
1st Myth: Is back pain short lived?
There are lot of research studies revealing that 50% of those who experience low back pain will suffer recurrent painful episodes throughout their lifetime or develop persistent pain.
Robin McKenzie, a researcher and author of Treat your own back says, “back pain really is a lifelong problem for some, and education and explanation to instil self-sufficiency is imperative.”
At the clinic we see clients who have suffered with recurring bouts of back pain due to various factors such as desk ergonomics, pregnancy, the wrong techniques when exercising, posture and many more. When there’s a lot of pressure on the back or it is forced into uncomfortable and unnatural positions pain will occur but learning how to adapt the correct posture and techniques should control the pain.
Other conditions such as Osteoporosis can cause back pain among clients. Research by the Osteoporosis society found that as we get older our bones start to lose strength and density and this can result in pain; therefore as we age pain is almost inevitable.
For many back pain isn’t short lived and it could be a lifelong battle.
2nd Myth: Manipulation is a cure
Adjustment or manipulation of back and neck problems have become common treatment methods. These methods are used by Chiropractors, Osteopaths and Physiotherapists. Whilst this treatment method can be very beneficial, it is not suitable for everyone suffering low back pain and it should not be used without education on how you can help yourself.
If manipulation is used solely to treat your back pain it could be a technique used to create dependence on a clinician. This means that you could be being denied the opportunity to understand and manage your own pain. There should be some some focus during treatment on exercise and activity that allows you the opportunity to explore how you can manage the issue yourself.
A study from the University of Washington showed that patients receiving the the McKenzie Method of treatment received fewer treatments compared to those treated by a Chiropractor, to achieve the same outcome. 72% of the McKenzie group also reported that in the event of back pain reoccurrence they would be able to manage their own pain.This is the outcome we want for you: fewer sessions and the ability to prevent and self-manage your back pain and to do this we use the McKenzie method.
3rd Myth: Ultrasound and electric therapies work
There is no supportive evidence that shows the positive effects of electrical devices such as shortwave diathermy and ultrasound treatment of back pain.
These treatments provide no long term benefit and do nothing to treat the underlying problem. Clinicians using these methods often describe how they will accelerate healing but please be aware that there is no scientific evidence to support this.
In 1995 the US Government Agency for Health Care Policy and Research reviewed a list of recommendations for healthcare professionals treating low back pain. Due to the absence of any evidence the agency could not recommend the various forms of heat, shortwave diathermy and ultrasound therapies. To date there is no fresh evidence to support their use.
4th Myth: Inflammation
There is a widespread belief that back pain is cause by inflammation. This belief is untrue.
Whilst inflammation does occur in the presence of some conditions such as rheumatoid arthritis,sudden acute pain is usually mechanical. This means the pain is caused by a problem with the moving parts of the spine due to spraining or distortion of the supporting ligaments around the vertebrae. This may result in minor displacement of an intervertebral disc.
5th Myth: Arthritis
Many of our clients believe that back pain is due to degenerative changes, arthritis or osteoarthritis. Let us put this myth right. Wear occurs in everyone with ageing. Just as our hair turns grey and our skin wrinkles, we get a little grey and wrinkly inside. The term ‘degenerative changes’ is therefore used to describe the normal wear and repair process, however this does not mean it causes pain. Degenerative changes can be seen on X-ray and are found in those with back pain as well as in those without it.
6th Myth: Rest
Whilst you may need to rest for a day or two when your pain first occurs, it is not a good idea to keep it up. The advice 20 years ago was to rest but research has shown that inactivity only makes things worse.
You may have been told to stop your sport but this advice is often not necessary. Sport is often mistakenly blamed for the onset of back pain and of course, sometimes sport is a cause, however more commonly there are other explanations. Whilst you may need to modify your sporting routine,very few back problems require stopping all sport especially if you feel better when you are active.As soon as your pain allows you should regain your mobility. You do not necessarily need to stop your sport either as the best way to deal with back pain is to stay active and continue doing regular exercise. If there is any sign of your pain reoccurring or your back stiffening up, get moving. Keeping active is one of the best strategies to help resolve back pain and prevent it reoccurring. One patient came to the clinic who walked off his longstanding back pain and sciatica. He realised he was more comfortable moving and walking, so decided to walk 3-4 hours a day. Within 2 weeks his symptoms had resolved.
If you’re worried about which exercises you should limit because of back pain, speak to one of our Physiotherapists who can advise about what you are safe to do.
Myth 7: Back pain is new
The high incidence of back pain apparent today is often blamed on our modern sedentary lifestyle, staring at PCs and slumping in front of the sofa. Researchers have challenged this concept and propose the idea that debilitating back ache is nothing new and was present millions of years ago, 4-million to be precise-long before screens and sofas.
What the research found about back pain…
- Dr. Asier Gomez-Olivencia, a Cambridge University researcher, examined fossilised spines in specimens of australopithecines, who lived 4.4 million years ago, right through to Neanderthals.
- He found among the bones of around 28 individuals in northern Spain, an almost-complete lumbar spine
- The way in which the bones developed and the way they changed due to wear and tear show that this individual is likely to have suffered severe back pain.
- So although living very differently to us, our ancestors may have suffered from back problems comparable to the conditions that cause us so much misery today.
What does cause back pain?
Over 70% of people will at some stage suffer from back pain-a clear indicator that this is a growing issue.
There are many factors that cause back pain including
- Injury to the small apophyseal ( facet ) joint at the rear of each spinal segment
- Damage to the capsule ( soft tissue covering ) that surrounds each facet joint,
- Stretching of ligaments that secure each vertebral body to the one above and below
- Overuse of injury to any of the small muscles linked to each spinal level.
- Bone bruising and damage caused by direct impact
- Irritation to the nerve endings and blood vessels in the low back area
- Injury to the intervertebral disc between each spinal segment.
With such a large number of possible structures that can cause pain, it is important that all episodes of low back pain are fully assessed and a treatment program is started straight away.
An initial assessment will enable an accurate diagnosis. Next all of the possible causative factors need to be eliminated and these may include; changing posture, reducing prolonged sitting with poor desk setup and correcting poor lifting techniques in the gym and at home.