So yes, it’s quite clear that back pain is a common issue! While everyone knows someone with a “bad back,” it seems that many people aren’t up to date on their knowledge of back pain causes and treatment.
There are many myths out there surrounding this subject — some are due to outdated information, while others are just plain wrong. Below, I’ve rounded up the most common myths I hear and tried to sort the wheat from the chaff.
If we look back 20 years, the advice given to a patient suffering from acute back pain was to lie flat on his back on a hard surface for a week — or two if you were lucky. While this is now an outdated approach, it seems the message regarding active recovery hasn’t been fully received.
Recommendations now center around keeping active within your comfort zone. Movement where possible is advised as it will prevent the back from becoming stiff, and movement encourages an increased blood flow to the area and drainage of the byproducts of inflammation.
It is important not to force the back to do something that causes severe pain to avoid doing any further damage, but certainly moving in any way comfortable is a good idea.
Let’s get this straight: Sciatica is a symptom, not an injury or condition. The thing with a symptom is that it can be caused by any number of issues.
Take fatigue, for example. Fatigue is a symptom of a large number of conditions including ME, pregnancy and viral infections — to name just a few.
Similarly, sciatica is a symptom of disc herniation, as well as spinal stenosis, facet joint irritation, sacroiliac joint dysfunction, myofascial trigger points and piriformis spasm. And this is not an exhaustive list, just the most common causes.
Unless you have an MRI scan with a clear spinal cord impingement — which matches the level of discomfort you are experiencing (see below regarding MRI scans) — don’t presume surgery is the only option.
When suffering from acute or chronic back pain, many people will be referred for an MRI scan by their family doctor. Magnetic resonance imaging (MRI) is a great tool for looking at the back in detail as it will show us the bones, joints, discs, muscles, ligaments, tendons and so on.
But does an “abnormality” on your scan really tell you the cause of your pain?
A large majority of people without back pain will demonstrate some form of abnormality on an MRI scan. Minor disc herniation is a common finding as is degenerative wear and tear, but they do not always correlate with pain.
So before you go rushing off to surgery, make sure the abnormality on the scan really is the problem causing your pain.
It is true that lifting with bad form is a common cause of back injury. The spine should remain straight while the knees bend to take the load. This is common knowledge, but so few implement it properly.
However, in my clinical experience, far more cases of back pain are less sudden in their onset. Far more common are cases where pain is caused by sacroiliac joint and facet joint dysfunctions, muscular strain and spasm, and postural issues such as lower-crossed syndrome (anterior pelvic tilt with associated muscle imbalances).
Many people believe that because one or both of their parents suffered with back pain, then they will as well. In most cases this is just not true.
There are, of course, some conditions that cause back pain that are inherited from an individual’s parents — ankylosing spondylitis, for example. There is also some indication that a particular gene may be present more often in those with lumbar disc degeneration.
But for the most part, back pain is more frequently caused by mechanical injuries, movement dysfunctions and posture issues than anything genetic.
The spine is an amazing structure. It is flexible enough to allow a wide range of movement, sturdy enough to provide attachment for countless muscles and strong enough to act as a protective casing for the spinal cord — damage to which can be fatal.
Going back to its strength, it is not easily injured. It takes a considerable force to injure or damage the spine by way of a fracture. It is more likely injured over a long period of time whereby repeated postures and movement patterns causes degeneration.
This is not a sign of weakness in the spine itself, but more the effect that issues elsewhere in the body will have on the spine.
Poor posture is mostly caused by muscle imbalance. The muscles that attach to the spine affect the positioning of the spine and may cause more stress on certain areas, resulting in an unnatural wear pattern. The same is true of repetitive movement patterns.