Back pain

Back pain is a common problem not only in the UK but worldwide.  As physiotherapists, a high percentage of our workload is helping people address and manage their back pain, which can be acute or longstanding in nature.  Most people will suffer at least some episodes of back pain during their adult life, so knowing how to deal with the symptoms quickly and effectively is very important.

There are some common myths surrounding back pain and management which can prove to be barriers to your recovery:

Myth 1 : “Moving my back will make the pain worse”

During an acute flare of back pain, some movements can be very uncomfortable or painful, pain is a complex concept and whilst initially it can be a useful reminder to modify your activity levels we know that gentle movement and activity is more beneficial than bedrest for most people.  Restoring normal movement to your back as soon as possible is important to recovery, try some gentle pelvic tilts in sitting or lying, some gentle knee rolls from side to side whilst lying down, or hugging your knee to your chest to help mobilise your back.  Changing your position regularly can also be useful as people often find prolonged, static postures can cause increased discomfort.

Myth 2 –“ I should avoid weight training and should take up Pilates or core exercise which is better for my back”

When it comes to exercise for back pain there are no hard and fast rules.  We know that strong, fit, flexible backs are the best backs to have, but how you build strength, fitness and flexibility can vary from person to person.  A Physiotherapist can help to advise with regard to what specific stretches may be beneficial for you, and also suggest exercises for particular muscle groups which may need to work harder.  Evidence suggests that there isn’t a particular form of exercise class which is better than any other when it comes to back pain, some may prefer pilates, whilst others feel benefit from cycling, using a kettlebell or Yoga, so do something you can tolerate and can enjoy.  When it comes to cardiovascular training for fitness, the exercise should be performed 3 times a week for 30-40 minutes continuously, and be something that gets you hot, sweaty and out of breath (unfortunately having an active job, or doing a short school run doesn’t count).

Myth 3 “A scan will show me exactly what is wrong with my back”

In most cases a scan will show normal changes that occur in the lower back over a period of time, we know that the majority of the population have these changes in their back.  They are even found in the majority of those who never suffer with back pain.  In this way scans often throw up ‘Red-Herrings’ and there is a growing body of evidence to suggest scan results correlate poorly with a patients symptoms.  For this reason a scan alone is not particularly useful in explaining why someone might be experiencing pain.  It does not mean that all MRI findings are irrelevant, just that they do not always provide the answers that a patient is looking for.

Myth 4 “Pain equals damage”

Pain is a complex issue and is often not related to the amount of ‘damage’ or ‘change’ in the structure or tissues of your back.  It can be the way your body warns you that there might be a glitch or potential ‘threat’ in the system.  For example, imagine how horribly painful it can be to accidentally step barefoot onto a lego brick, yet when you examine the bottom of your foot there is nothing to see.  It is useful to consider other factors which have been found to correlate with back pain, for example, stress levels, sleep patterns, general health and exercise levels.  It is likely a physiotherapist will ask you about some of these factors during an assessment and try to help you develop some strategies to try to address them.

Whilst an episode of back pain can be very debilitating and frightening, it is likely it will improve and settle with time.  It is important to remember that if you are struggling to manage your back pain there are people who can help to guide your recovery and help you return to the exercise and activity levels you enjoy.