Back Pain: Myth Busting

A recent article on healthline quoted nearly $134 billion dollars spent out-of-pocket (this figure does NOT include money spent by insurance companies) on back and neck treatments in the US between 1996 and 2016, more than was spent on managing either heart disease or diabetes. Suffice it to say that back pain is a problem in the US – in fact 4 out of 5 Americans have reported an instance of low back pain in their lifetime.

With that kind of prevalence, it’s no wonder that there are such a wide variety of treatments and ideas surrounding back and neck pain out there.

Here are a few of our favorite myths:

1. Exercise is bad for back pain/Bed rest is best

You’ve probably heard of the RICE principle that this myth is likely based on – Rest, Ice, Compress and Elevate. Turns out, that while initial rest might help calm down a spasm, gentle movement and exercises that and progressively loaded are the best method to treat low back pain. Bed rest with low back pain may prolong your symptoms. It is recommended that you get active and mobile as soon as possible.

2. A physical therapist should use ultrasound to treat low back pain

While you might have had these treatments to treat an episode of low back pain in the past, as it turns out, there’s actually no evidence that passive treatments and modalities like ultrasound and e-stim provide long-term benefits or treat the root cause of why you’re having low back pain, nor do they speed up your overall recovery.

3. Bad posture will give you back pain

The truth? Staying in any one position will eventually cause discomfort. Your body was built to move, if you try to maintain ‘good posture’ for an extended amount of time, you will likely find yourself ready to change positions before too long. Try changing your position throughout the day, with different seated positions and standing. Give your self movement ‘snacks’ throughout the day by going for a walk, or getting a quick mobility session in between meetings.

4. ‘I need an x-ray or MRI to see what’s going on in there!’

Actually, ‘abnormalities’ found via imaging of the low back or spine are found in many people that do not report pain. Arthritis is present in over 90% of people between 50-55 years of age, yet only 10% of those report low back pain. Additionally, there is good evidence to suggest that immediate lumbar spine imaging in patients with low back pain and without reason to suspect a serious underlying condition did not improve outcomes compared with usual clinical care without immediate imaging;

‘Clinical care without immediate imaging seems to result in no increased odds of failure in identifying serious underlying conditions in patients without risk factors for these conditions.’

While it’s likely that you will experience an episode of back pain at some time in your life, and while back pain can be initially debilitating, most people will improve over the course of a few weeks, and continue to improve in the following months. There is a small percentage of people that will deal with chronic back pain issues; pain is a complicated issue. It is highly correlated with other personal and environmental factors, in addition to a person’s genetic make up. At the first twinge, go see your physical therapist. Getting a full assessment and starting with a personalized program to treat your pain will help you get back to things you love to do sooner!