Back Pain: 16 Back Pain Truths and Myths

Back pain is extremely common.

The Truth About Back Pain

Back pain is extremely common. In fact, 80% of people will have significant back pain at some point in life. Back pain symptoms vary from person to person. They can be sharp or dull, lasting or brief. Myths regarding back pain are also common. Can you recognize the myths and facts that follow?

Sitting up too straight and still can also irritate the back.

Myth: Always Sit Up Straight

We know slouching in chairs is bad for your back. However, sitting up too straight and still can also irritate your back.

For relief of back pain from prolonged sitting, intermittently try leaning back in your chair with your feet on the floor with a slight curve in the low back. Also, stand for part of the day when possible (for example, while on the phone or reading).

When lifting, try to be as close to the object as possible.

Myth: Don't Lift Heavy Objects

When lifting, it's the way you lift that is most important, not just the weight you are lifting. When lifting, try to be as close to the object as possible, squatting to make the lift. Use your legs to lift. Don't torque your body or bend during the lift but be careful, do not attempt to lift heavy weight beyond your capability.

Strict bed rest was once common medical advice for back pain.

Myth: Bed Rest Is Always Best

Bed rest can help an acute back strain or injury. But it is not true that you should stay in bed. Sometimes remaining immobile in bed can actually make back pain worse. Strict bed rest was once common medical advice for back pain. But doctors today are more likely to recommend moderate activity as you heal.

Woman falling off of a ladder.

Myth: Pain Is Caused by Injury

Sure, if you lift heavy objects at work routinely, you are more likely to have back pain. Posture and the weight of the things you carry certainly can cause or exacerbate your pain. But workers with sedentary jobs are actually more prone to disk injury than those who are moderately active at work. And as many as 85% of people who have back pain can't recall a specific moment when it occurred. That suggests many other things are more likely to cause back pain than injury, such as disk degeneration, infections, and conditions that are inherited, such as ankylosing spondylitis.

Back pain is more common in those who are unfit or overweight.

True: More Pounds, More Pain

Keeping fit is helpful in preventing and easing back pain. Back pain is more common in those who are unfit or overweight. Those who only exercise intermittently (the weekend warriors) are at increased risk for back injury.

People who are too thin can also be at risk for back pain.

Myth: Skinny Means Pain-Free

People who are too thin can also be at risk for back pain, especially those with eating disorders and osteoporosis.

Regular exercise is very good for preventing back pain.

Myth: Exercise Is Bad for Back Pain

Regular exercise is very good for preventing back pain. Actually, for those with an acute back injury, sometimes a guided, mild exercise program is recommended. This often begins with gentle exercises that gradually increase in intensity.

Spinal manipulation and massage can help for many forms of lower back pain.

True: Chiropractic Care May Help

Some patients say spinal manipulation and massage can help for their lower back pain while others may get little or no pain relief.

A woman gets acupuncture.

True: Acupuncture May Ease Pain

Acupuncture may be helpful for relieving many types of back pain that do not respond to other treatments. Yoga, progressive relaxation, and cognitive behavioral therapy may also be beneficial.

A young woman lies on her back.

Myth: A Firm Bed Mattress Is Better

People differ in their response to mattress firmness. One study from Spain showed that those who slept on a medium-firm mattress (rated 5.6 on a 10 point hard-to-soft scale) had less back pain and disability than those who slept on a firm mattress (2.3 on the scale).

Most specialists recommend treatment without surgery as a first step.

Myth: Slipped Disks Require Surgery

The cause of back pain is unknown more than 70% of the time. Even when tests confirm a disk is damaged, you may not need surgery. MRI studies show that when a disk herniates (bulges, ruptures, or protrudes) the damaged disk area often improves on its own after time has passed. After six weeks, 90% of slipped disks will have gradually improved. Most specialists recommend treatment without surgery as a first step. If back pain hasn't improved using more conservative therapy, surgery may then be recommended.

Spine abnormalities are as common in people without back pain as those who have it.

Myth: X-Ray, MRI Can Always Find the Cause

Machines that can look deep inside your body—X-ray, MRI, CT scans—don't always work well for back pain. The truth is, spine abnormalities are as common in people without back pain as they are in those who have it. And if your muscles spasm or if your ligaments are strained, it won't show up on one of these imaging tests. That's why a thorough physical examination is often more useful.

Only a small percentage of back pain sufferers are disabled by their condition.

Myth: Back Pain Is Often Disabling and Chronic

Back problems are often extremely painful at first. But most people improve quickly over the course of a few weeks, and they usually improve even more after a few months. Still, it is common for back pain to return from time to time. The good news is that only a small percentage of back pain sufferers are disabled by their condition. Most can continue their favorite activities relatively quickly.

Two people with very similar back problems may report very different levels of pain.

Myth: Major Pain = Major Injury

Not necessarily. Pain is more complicated than you might think. Two people with very similar back problems may report very different levels of pain. The brain's ability to sense and express pain seems to be "tuned up" more highly in some people than in others. Personal and environmental factors, as well as genetics, all play a part in how you perceive pain. So, when it comes to your back, extreme pain does not always add up to serious injury.

Does sitting all day at work cause back pain?

Myth: Sitting All Day Causes Lower Back Pain

Are you a desk jockey? If you sit all day at work, you can really feel it in your back. But does sitting all day at work cause back pain? It should be good news for office workers everywhere that the answer seems to be "no." After reviewing 24 studies that all looked for associations between desk jobs and lower back pain, one review concluded that there was no evidence for any connection between the two.

What you believe can impact your back pain.

True: Your Beliefs Influence Your Improvement

Can you believe it? What you believe can impact your back pain. Talk about a good reason to separate back pain myth from fact! Studies show that when patients believe they have a serious structural problem with their back, they are more likely to develop chronic lower back pain. That's also true for people who rest more than they need, and for those who fail to control their back pain. These are good reasons to find a doctor or physical therapist with experience in treating back pain. With the right information and advice, you may soon be on the road to recovery from your back pain.

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REFERENCES:

  • Alberta Occupational Health and Safety: “Seven myths about back pain: OHS information for workers.”
  • American College of Physicians, 2013.
  • American Pain Society, 2013.
  • Irish Society of Chartered Physiotherapists: “Move 4 health 2011: Challenging back pain myths.”
  • The Spine Journal: “Causal assessment of occupational sitting and low back pain: results of a systematic review.”
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