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The many myths of back pain

By Carley King
Chartered Society of Physiotherapists

image copyrightThinkstock
image captionBack pain shouldn't stop people doing their normal level of exercise

Back pain is a leading cause of disability worldwide, and in the UK it is one of the main reasons people miss work.

As with anything so common, myths have developed over time about what causes it and how best to deal with it.

It's understandable why these misconceptions arise. Indeed, some would have been the accepted belief in healthcare circles before new evidence emerged to give us fresh insights.

So healthcare professionals have sometimes been guilty of perpetuating the myths; both with patients and in the media.

Why all of this matters is that they can cause fear among people with back pain that influences their behaviour.

We know that the best way to tackle back pain is to keep moving, but if fear stops people from doing that recoveries can be hindered, or even reversed.

Clinicians see the consequences of this fear every day. so the Chartered Society of Physiotherapy has a new campaign aimed at busting these common myths.

'Moving will make my back pain worse'

We have moved on from the time when total bed rest was believed to be needed, but there remains a fear of twisting, bending and moving in general.

This fear is understandable - it can be very painful - but it is essential to stay on the go.

Gradually increase the amount of activity you do, and try to avoid long periods of inactivity.

'I should avoid exercise - especially weight training'

If you don't normally lift weights, we're not suggesting you head out today and get under a 100kg squat.

However, back pain shouldn't cause you to stop doing exercise or the regular activities you enjoy.

Exercise is now accepted as the best way to treat back pain and this includes weight-training, where appropriate.

As with anything, gradually build up your tolerance and confidence but do not fear it.

'A scan will show me exactly what is wrong'

This is a fascinating one, and counters the view that technology holds all the answers.

In some cases, a scan will be necessary.

But most often it won't and what's more, there's some evidence to show that seeing the results of a scan can actually make a person's condition worse.

Here's how.

Even people without back pain can see changes to their spine on a scan or X-ray - evidence of that is not, therefore, an indication that anything is wrong.

But if you do have back pain, and you see changes in a scan, you may become fearful of exercising and doing the other activities that I discussed earlier.

That means having a scan that didn't actually reveal anything useful caused you to stop doing the very things you need to do to get better.

'Pain equals damage'

This is one that was always the established view, but recent research has led to greater insight on what causes pain and how best to manage it.

That's why, as physios, we take a more holistic approach to help patients understand why they are in pain.

There may be physical reasons but there may also psychological or even social factors at play, and it's important to identify and address those.

The key again, as with all of these myths, is to overcome the fear factor to avoid a person's condition worsening.

Of course, I should point out that this advice is general in nature, will not apply to everyone and anyone who experiences back pain that lasts longer than six weeks is advised to see a physiotherapist or GP.

But if we can begin to knock down these myths, we can start to make inroads on a condition that affects millions of us every day.

More on this story

  • Up to half of UK people living in pain

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