Applying WD40, rolling over sofa arms and hanging from doorframes are just some of the odd “cures” back pain sufferers have tried, according to members of the British Chiropractic Association (BCA). Their research revealed that half of those polled believe you should always rest a bad back – increasing to 64 per cent in 16-24 year olds – whereas moderate activity is far better for recovery. And over 40 per cent believe back or neck pain is simply part of the ageing process when, in fact, lifestyle factors such as inactivity are more often to blame. We take a look at some of the myths surrounding back pain and what you should really be doing to alleviate it.
MYTH: BACK PAIN MEANS DAMAGE OR INJURY
Back pain is very common with 84 per cent of people experiencing some pain in their lifetime but it is rarely serious. A mere one per cent of back pain disorders are related to cancer, infection, fracture or an inﬂammatory process while only ﬁve per cent of back pain is associated with nerve compression. Marc Sanders, a chiropractor in Winchester with the British Chiropractic Association, explains: “I like to use the analogy of a paper cut (which really hurts even though it’s just a minor wound). The level of pain you experience is very rarely proportional to the amount of injury sustained to the back.” Scientiﬁc evidence shows that the “volume switch” for back pain can be turned up by a variety of factors, such as past experiences of pain, health (low energy, feeling tired) and lifestyle (being overweight, sedentary lifestyle, poor sleep patterns), while psychological factors (low mood, stress and depression) also play a big part in pain perception. However if pain persists, it’s always advisable to seek a professional medical opinion.
MYTH: EXERCISE MAKES BACK PAIN WORSE
Rest and inactivity means your pain is likely to take longer to resolve because the back – like all body parts – is designed for movement, says Marc: “Exercise has been consistently shown to be the best intervention for treating low back pain – whether it’s acute pain (lasting up to six weeks) or chronic (lasting at least three months),” he says. Walking, running, cycling, swimming, yoga and Pilates are all very good for back pain but the best exercise is the one you like doing and will stick with.
MYTH: PAINKILLERS WILL SPEED YOUR RECOVERY
Although ibuprofen is often the ﬁrst-line treatment for GPs dealing with acute attacks of lower back pain, a major trial showed it does not help recovery or reduce pain levels. Researchers in Sydney say advice and reassurance can do as much for back pain as regular doses of ibuprofen. “Most back pain is mechanical so some sort of hands-on treatment or movement or exercise will more likely manage the problem,” explains Marc. “Painkillers can be useful – in the short term – by helping people to start moving earlier, but I would recommend more conservative therapies, such as the use of a heat pack, manual therapy (massage, spinal manipulation, or acupuncture), gentle home stretching and short walks within your pain tolerance.”
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MYTH: LIFTING CAUSES MORE BACK PAIN THAN SITTING
“Research has found that people who do desk jobs suffer more back pain than those working in manual jobs where lifting is involved,” explains Tim Hutchful, of the British Chiropractic Association. Sitting causes up to twice as much pressure on discs as standing. If your job involves sitting for long periods, move and change posture every 20-30 minutes as it’s the inactivity that causes pain. Using your joints and spine actually strengthens them, reducing risk of injury. And when you are lifting, focus on gradual strength training over time, whether lifting boxes at home or weights in the gym, advises Marc.
MYTH: A SCAN IS THE ONLY WAY TO DIAGNOSE BACK PAIN
“There is no scan available that can tell you where your pain is,” says Marc. “Imaging or scanning is just one piece of the puzzle when diagnosing the cause of back pain.” The problem is that a scan will probably always show something: one clinical study showed ﬁndings of arthritis, disc problems and “pinching” nerve roots among adults ranging in age from 20 to 80, yet none of them had back pain. “It’s common to ﬁnd changes such as ‘degeneration’ on scan reports, which may not necessarily be the cause of pain and are often part of ageing,” says Marc. “Somebody’s clinical history and a physical assessment can help to create a more complete picture when it comes to determining the cause of somebody’s back pain.” Scans are only needed when a serious condition is suspected, such as cancer, fracture or infection.
MYTH: SURGERY IS OFTEN REQUIRED TO FIX BACK PAIN
“It’s actually the opposite,” says Marc. “For the vast majority of back pain, surgery is not required and should be a last resort once all other options have been explored.”
MYTH: YOU JUST NEED TO STRENGTHEN YOUR CORE
The core stability craze started in the 1990s and since then it has pretty much been taken for granted that certain abdominal muscles are vital for stabilisation of the spine and that strengthening core abdominal muscles can prevent and reduce back pain. However, this isn’t backed up by science. Professor Eyal Lederman, author of the research paper The Myth of Core Stability, found that weak or dysfunctional abdominal muscles will not lead to back pain, and core stability exercises are no more effective than, and will not prevent injury more than, any other forms of exercise. Many people don’t exercise to strengthen their abdominals and don’t have back pain, so it’s better to focus on whole body strength.