Low back pain
1. Low Back Pain is common
Have you ever had lower-back pain? A niggle, a sharp pain, a dull ache, stiffness…? It’s highly likely you have, in fact, you would be in the minority if you have not experienced low back pain. A whopping 80% of our population is expected to experience an episode of lower-back pain at some stage in their lifetime. This seems quite alarming but only a very small number of those will suffer from ongoing chronic and disabling issues. The majority of low back pains improve in the short term (2 weeks to 3 months).
2. Scans are often not necessary
Consult with your therapist or GP before racing off to get a scan (and read the next fact below). In most instances, a scan will be unnecessary for back pain; your health professional will be able to determine if you require a scan after conducting a thorough assessment and medical history. When it comes to back pain a scan will often show things that are not connected with the pain you feel (again, read below).
3. Disc degeneration and bulging discs are often NOT the cause of your low back pain
You’ve been sent for a scan for your back pain, and the results are in – you have a bulging disc. Great; your pain is explained, or is it?
Numerous studies have shown that structural abnormalities such as degeneration and herniated discs are poor predictors of back pain. One such study where MRI scans were conducted on subjects with no back pain showed that fifty-two percent of the subjects were shown to have at least one bulging disc - yet they had no pain! (1) As the graph from the study below by Brinjiki et al, 2015 shows, degeneration as we age is normal and often not associated with pain.
4. Movement and exercise is important for recovery from low back pain
Back pain can be debilitating and painful and make you want to crawl into bed and stay immobile. The first few days following injury, avoiding activities that aggravate your pain is sensible but bed rest, in most cases is unnecessary and counterproductive. Evidence shows it is important to gradually get moving again and partake in your normal day-to-day activities, including lifting, twisting and bending, all of which help to strengthen and retain movement in the back. Avoiding doing such movements will mean a slower recovery. Even better news is that a variety of activities are great for low back pain with no one type shown to be more effective. This means you can participate in a physical activity that you enjoy, rather than one particular exercise or activity.
5. Poor posture and weak core strength are not to blame
This will be a shock to most of you! How many times have you been told to work on your core strength or to watch your posture? For many cases of low back pain, posture and core strength are not contributors. In fact, focusing solely on your core strength can create excessive stiffness in the very areas we require more movement and mobility. Many studies are now proving that although core strength may improve low back pain it has no greater impact than any other general exercise, so again exercise and movement that you enjoy is the key. Decreased range of movement and stiffness does cause back pain. A varied exercise routine of high and low load types along with decreasing stiffness and improving ROM is they key when developing a rehab program for someone with low back pain.
Likewise, with posture, the key is to move! Don’t stay in the same posture for an extended period of time, even if you’ve been told it’s the correct posture. When sitting behind a desk, move often, change your posture, get up and walk around most of all feel relaxed in your movements.
Boden SD1, Davis DO, Dina TS, Patronas NJ, Wiesel SW. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am. 1990 Mar;72(3):403-8.