Low back pain is debilitating, it can severely disrupt our ability to work, exercise and just live in general. It can be frightening.
During a work week at Marna Physio I will easily treat over five patients with acute low back pain . In fact, I will go as far as saying it is in my top three injury presentations each week!
Did you know 80% percent of people will experience at least one episode of low back pain in their lifetimes?
As a Physiotherapist it is critical to understand our patients perspectives of their low back pain. It provides us with a glowing insight into their coping strategies, self-efficacy and will guide treatment significantly.
When I ask “what is your understanding of your low back pain” I can get some very, very different answers.
Let's discuss some of these very common thoughts and why some are inaccurate (and not helpful!).
‘My back is weak, delicate and vulnerable’
Our backs are incredibly strong, flexible and robust!!! Our spines are designed to withstand incredible amounts of force and load.
Sometimes the cause of low back pain can be as simple as picking up a pen or tying your laces. Because of this, it is easy to fear that the back is weak and fragile.
It is important to know that PAIN DOES NOT EQUAL TISSUE DAMAGE and that the simple act of bending over may have been the ‘trigger’ to a painful experience but there would have been many other contributing factors that lead to that single event. The ‘cup of water’ analogy by Greg Lehman is often used to describe this phenomena.
To read more about this check out Greg Lehman's article.
‘My back is out of alignment... something has slipped’
If you have seen a health professional before, it is likely that you have been told that your spine is ‘misaligned’ or that a vertebral disc has ‘slipped’ from its origin.
Not only are these comments incorrect, but they are potentially damaging. The research has shown us that discs simply do not ‘slip out of place’. They are bound extremely firmly between bones (your vertebra).
Furthermore, humans are rarely symmetrical and we are born with misalignments! Some of the greatest athletes in the world including Usain Bolt (sprinter) and Lamar Gant (powerlifter) have ‘severe’ scoliosis with no pain!
‘My scans tell me I’m broken’
This is a very common belief. It is comforting to know exactly what may be happening through imaging when we are experiencing pain… but unfortunately it is not as simple as that.
As mentioned earlier, pain does not equate to tissue damage. Two people with the same scans may present very very differently with their own pain experiences.
Don’t get me wrong, imaging CAN play a role. When a clinician identifies potential ‘red flags’ imaging is used to rule out anything sinister such as fractures or tumours. The good news is though that less than 10% of cases require further investigation and your physiotherapist will screen for these rare cases in every examination.
Ordering imaging when it is not indicated can worsen the situation as we can become even more frightened of the anatomical changes or ‘damage’ that may be present in an asymptomatic individual.
‘Exercise is dangerous, I need to bed rest’
An ACTIVE approach to low back pain is critical. Bed rest or relying purely on passive modalities can actually worsen the situation. Our bodies are designed to move, and the simple act of walking, stretching or exercising has incredibly effective healing properties that are required for recovery!
Of course, severely aggravating an already painful structure is not recommended. Chat to one of the physiotherapists at Marna to discuss 'how much' is appropriate.
‘I’ve had 5 days in a row of severe pain, I am never getting better again’
Even as a physiotherapist who has knowledge in time frames for tissue healing and injury rehabilitation even I can admit I am guilty of this one! When we are injured it is natural to catastrophise and fear the worst.
Our judgement can be clouded, and we can be considerably impacted by that anonymous post online describing an episode of low back pain that never settled.
Most people will recover within 2-6 weeks and approximately 85% will recover in three months.
Okay, enough with the Myths… what can I do?
As usual, every case is different. Have a chat to one our Physios at Marna for an assessment to ensure nothing sinister is occurring. Your physio will have a discussion with you regarding the best treatment strategies or plan going forwards for you.
Management strategies often involve a combination of education, activity management, exercise and short term pain reduction strategies such as massage to encourage more movement!
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