Back Pain: Busting the Myths

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Low back pain – those of us who have experienced it know that it makes us miserable. It might be a sharp stab. It might be a dull ache. Sooner or later, 8 out of 10 have back pain. Every one seems to offer friendly advice on how to get rid of the pain – but do they really know what they’re talking about? Some commonly accepted recommendations may do more harm than good to you; many myths and misconceptions about back pain and back problems persist.

To me, high quality education about back pain can be an effective adjunct to treatment. This article puts to rest a number of common misconceptions about back problems – general myths, myths about diagnoses and causes of back pain, and myths about treatment options.

Let’s set the record straight about what you may have heard.

Myth : I won’t get back pain

Just because you haven’t had back pain yet doesn’t mean it couldn’t happen in future. The key to avoiding back pain is prevention. By using proper technique when sitting, lifting, and moving, you can help maintain a healthy back. Did you know? 80% of people will experience back pain at some point in their lives

Myth: I’m physically active, so I shouldn’t get back pain

While it’s true that well-conditioned individuals are less likely to have an episode of back pain than sedentary individuals, back pain can affect all people regardless of the level of activity. Some sports are more likely to cause back pain, such as golf, volleyball and gymnastics. In all cases, however, the back should be considered a priority in conditioning, because it creates a stable platform from which the arms and legs work.

Myth : Being overweight doesn’t contribute to my back pain

Extra body weight compresses the spine and squeezes intervertebral disks, making an overweight individual more prone to painful back conditions. In addition, high amounts of belly fat can cause poor posture and slouching resulting in back pain.

Stay fit by doing back and abdominal exercises to keep the core area of the body strong and healthy. This is an important way to prevent back pain and remain healthy.

Myth: Slim people don’t have bad backs

It’s true that keeping a low weight may prevent some back pain, but it’s very far from any guarantee. Sometimes back pain can happen that has nothing to do with personal weight, and overly thin people can have more delicate structures that do not support the spine as well, resulting in… you guessed it – bad backs.

Myth: If I have back pain and back problems when I am young, it will get worse as I age.

The incidence of back pain is actually highest between the ages of 35 and 55. After age 55, people usually have less pain – especially discogenic pain (back pain or other pain or symptoms caused by disc problems). While disc degeneration is a natural part of the aging process, it is not always accompanied by pain.

Myth: Don’t lift heavy things

It’s not necessarily how much you lift, it’s how you do it. Get directly in front of the object. Squat close to it, with your back straight and head up. Stand, using your legs to push up the load and your arms to hold it close to your middle. Don’t twist or bend your body, or you may hurt your back. (Of course you shouldn’t pick up anything that might be too heavy for you.)

Myth: Exercise is bad for back pain

This is a big one. Regular exercise prevents back pain. And doctors may recommend exercise for people who have recently hurt their lower back. They’ll usually start with gentle movements and gradually build up the intensity. Once the immediate pain goes away, an exercise plan can help keep it from coming back.

Myth: Rest is the best way to help my pain.

A short period of bed rest may help reduce acute pain of neck or back, but doctors generally advise against more than 1 or 2 days of bed rest. In fact, resting and general inactivity can actually cause more pain. Inactivity leads to muscle wasting and other harmful effects, which in turn can create more back pain or neck pain and lead to an unhealthy cycle of pain/inactivity/more pain/more inactivity.

Myth: It’s better to sleep on a hard mattress

Different people have different reactions to mattress hardness. A study in Spain showed that people who slept on a medium level hard mattress suffered less back pain than people who slept on a very hard mattress. If a hard mattress works for you, great, but if it isn’t comfortable, you’ll just have more back pain. So go with your inner feeling and the habits that work for you.

Myth: An MRI scan or other diagnostic test is needed to diagnose my back problem.

Most health professionals can develop a successful treatment approach based on a thorough medical history and physical examination. Only specific symptom patterns in a minority of cases indicate the need for an MRI scan or other sophisticated tests. Typically, an MRI scan is used when patients are not responding to appropriate back pain treatment.

Myth: The abnormality/back problem on my MRI scan needs to be cured

An abnormality that is seen on an imaging test (MRI, CT scan) does not necessarily cause back pain or other symptoms. In fact, the vast majority of people who never have had an episode of low back pain will have abnormalities (such as a herniated disc or degenerative disc) on an imaging test.Myth  : Mostly it requires surgery, eventually

If you’re afraid to see a doctor to treat your back pain for the fear that you’ll need surgery, chances are you’re worrying needlessly. Unless your pain is unrelenting and no form of treatment seems to work, or you develop a serious neurological deficit – such as a foot drop – you shouldn’t rush to surgery. Many common back problems – even those that cause severe pain – resolve themselves over time  Only in the most serious cases of back pain, when other pain management treatments have not worked, should surgery be considered. For patients experiencing low back pain, 92%-96% can be treated successfully without back surgery

Myth: Pain, It’s all in my head

Pain is a very real thing and should never be dismissed. Pain can take a lot of energy, induce stress, and have negative effects on the body.

Myth : I will just have to live with the back pain as pain is a normal part of aging.

You should never just accept body pain. It is your body’s way of telling you something is wrong. There are countless options for back pain relief .

Myth: Blocks/injections given in back for low back pain have side effects.

Depending on cause and source of pain, various  pain procedures like Transforaminal nerve root block, ozonucleolysis, facet joint block, sacroiliac joint block are done under fluoroscopic guidance. Theses procedures have a diagnostic role. These procedures have a success rate of more than 90% with no side effect. In most cases the use of single treatment method is insufficient in relieving pain.

  • Multimodal approach is necessary for back pain.
    • Combined  drug therapy is very useful &  ideal   combination in treating moderate to severe chronic pain.
    • Adjuvant therapy is necessary in most cases.
    • Physiotherapy & Rehabilitation is essential too
    • Interventional Pain Management works in most situations where all other options has fail.

Dr Syed Arif Hussain  Consulting  Anesthetist &  Pain Specialist, Govt. JLNM Hospital Rainawari, Srinagar