Back Truths: Debunking Common Myths about Back Pain
As with any pain condition, it’s important to learn as much as you can about your condition. Here are some common myths about back pain.
Myth: Getting plenty of rest is the best defense against back pain.
Truth: Resting in bed or lying on the couch for too long can actually delay recovery and make your pain worse. That’s because staying in the same position for too long can result in stiff joints and muscle weakness. For most cases of back pain, you should only rest for a short period of time - usually one or two days - as advised by your health care provider. Not using your muscles can result in a 12% loss of muscle strength a week, according to studies.
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So even though you might cringe at the thought, experts say it’s important to get up and walk around every hour or so to help keep your back strong. Daily exercise and conditioning can support the back by building muscle; improving posture, balance and flexibility; and reducing pressure on the vertebrae.
Myth: Back pain usually requires surgery.
Truth: Despite what many might fear, surgery is rarely needed to treat back pain and should only be used as a last resort if the pain doesn’t respond to other therapies. Even in cases where there is disk damage or some type of nerve problems, back pain will likely resolve on its own over time with more conservative therapies. For example, according to the American Academy of Orthopaedic Surgeons, although a herniated disk can sometimes be very painful, most people feel much better with just a few months of nonsurgical treatment.
Myth: People who perform manual labor for a living are at greater risk for back injury and pain than office workers.
Truth: It’s true that lifting and transporting heavy objects or materials puts a lot of added pressure on the back, upping the likelihood of back injury and pain. That’s why nursing, construction and factory work tops the list of occupations with work-related back injuries and lost work days. However, people in sedentary occupations, particularly those at desk jobs are at higher risk of disk injury than those who do moderate amounts of physical labor. Sitting hunched over a desk for hours on end, especially for those with poor posture or an unsupportive chair, can be a major source of back pain.
Myth: The cause of back pain is usually easy to identify.
Truth: Back pain can be complex and difficult to diagnose. For example, the vast majority (upwards of 85%) of low back pain cases cannot reliably be attributed to a specific disease or spinal abnormality, according to the American Pain Society. In some cases, back pain can also be a signal of a more serious health issue (for example, kidney problems, spinal infection or tumors).
Myth: Walking and hobbies like gardening are bad for my back and may slow recovery.
Truth: In most cases, staying active is a key part of managing back pain and doing so will also help you feel better mentally, physically and emotionally.
While it’s understandable and appropriate to avoid activities that cause you more pain, be careful not to let a fear of hurting yourself get in your way. Movement can help speed up the healing process and prevent future flare ups; being inactive can complicate and prolong the pain.
In particular, it’s important to focus on strengthening your “core” - your pelvis, back and abdominal muscles. As always, talk with your health care provider about the type and amount of exercise that is right for your condition. Also ask how you can modify your favorite activities so they are easier on your back.
If you suffer with chronic back pain (pain that lasts more than three months), you may benefit from more intensive conditioning through physical therapy. Physical therapy is a program of specific exercises and treatment techniques designed to ease pain, improve function and range of motion and try to ward off future back pain flare ups.
Myth: A firm mattress is best.
Truth: For years, people with back pain have been told to sleep on a hard mattress. But harder is not necessarily better. Research has shown that those who sleep on a medium-firm mattress were twice as likely to report a lessening of back pain symptoms while lying in bed and when getting out of bed and were also less likely to need pain medications than those sleeping on a firm mattress. Experts believe that the softer mattresses may place less pressure on the shoulders and hips, which enables a more natural position for sleep often in the fetal position.
Myth: Only people who are obese or overweight are at risk for back pain.
Truth: People of all shapes and sizes can experience back pain. Being underweight can also be a problem, placing the person at greater risk of back problems and associated pain due to vitamin deficiencies or weak bones.
Myth: If I’m physically fit, I don’t have to worry about back pain.
Truth: While it’s true that people who are in good physical shape are less likely to have an episode of back pain, all it takes is one wrong move or an unexpected injury/accident and you could wind up in pain. Back pain can affect people of all fitness levels, and don’t forget that certain sports (for example, golf, football, gymnastics, tennis) may put you at risk for back or neck strains because of the twisting, turning and even bodily impact involved. Athletes may try to fight through their pain for the sake of the game, but avoiding medical help can lead to additional and more serious injury.
Myth: There’s nothing that can be done for chronic back pain - you just “have to live with it.”
Truth: Unfortunately, too many people living with chronic pain have heard these words.
In most cases, back pain goes away on its own over time. But for the 26 million Americans dealing with frequent and persistent back pain, there are many options for treatment and no one should have to suffer through it. Clinicians want to take care of their patients, so they can get frustrated when their patients don’t get better despite their best efforts. Be persistent in telling your health care provider how your back pain is affecting your everyday life and ask about other approaches you might be able to try - a new medication, water therapy, acupuncture, a more intensive physical therapy program and the like. Use APF’s Targeting Chronic Pain Notebook to help track your pain symptoms every day.
Myth: You should expect to have an X-ray, MRI or other diagnostic scan to help diagnose back pain.
Truth: Imaging tests like X-rays, MRIs and CT scans aren’t usually ordered unless you have suffered a trauma to the back or if your back pain persists without relief for several weeks or more despite using conservative therapies. Clinicians do not routinely order diagnostic tests for patients with nonspecific back pain. This is due, in part, to the fact that even the most sensitive imaging won’t reveal a muscle spasm or strained ligament that might be causing the pain.
In most cases, your health care provider will ask you about your medical history and any recent injuries. He/she will perform a complete physical exam and may touch different parts of your back to locate the painful areas and ask you to do a few simple motions to see if you have full range of motion or if you have any weakness.
Myth: Most back pain is due to irreversible injury to the spine.
Truth: In fact, the most common cause of back pain is a muscle strain. A muscular strain is the result of an unexpected force or pull on the muscles of the back. Ligament sprains, or injuries to the back’s fibrous bands of tissue when they are stretched beyond their means, are another common cause of back pain.
Myth: Once treated, back pain won’t return.
Truth: Unfortunately, if you’ve had an episode of back pain, you’re at greater risk of experiencing it again. The good news is that there are many things you can do to help prevent or minimize the impact of the next back pain flare up. Simple steps include improving your posture and exercising and strengthening your core muscles. For more information, read Finding Relief: 10 Ways to Manage Back Pain and Lifestyle Tips: Preventing Back Pain from the Start.
The information on this website is provided to help users find answers and support. Readers may wish to print the information and discuss it with their doctor. Always consult with health care providers before starting or changing any treatment.
The American Pain Foundation is solely responsible for the content, and maintains editorial control, of all materials and publications it produces. We gratefully acknowledge those who support our work. This project is made possible by support from Purdue Pharma LP.Back Truths: Debunking Common Myths about Back Pain