3 Low Back Pain Myths

Low back pain is common with the World Health Organisation reporting that in 2020, low back pain was the single leading cause of disability worldwide, affecting 619 million people (World Health Organisation, 2023). With this staggering statistic comes a range of information, including myths.

This article covers three myths of low back pain and why understanding these myths is helpful for managing pain and function when living with low back pain. This article includes information as seen in the video Low Back Pain Relief Exercise Rouitne + 3 Low Back Pain Myths and forms part of the Back Pain Series. 

When it comes to low back pain it is important to understand the nature of the pain. This includes how long the pain has been present. Pain lasting under 6 weeks is considered acute, subacute pain lasts 6 to 12 weeks, and chronic pain lasts over 12 weeks. The myths covered in this article are related to chronic pain rather than acute or subacute pain. That is pain lasting over 12 weeks.

In addition to understanding whether the pain is acute, subacute, or chronic, it is also important to understand if the pain is specific or non-specific. Specific pain can be attributed to a disease or injury such as a fractured vertebra, cancer, or referred pain from an organ such as a kidney. Non-specific pain is pain that is not attributed to a disease or injury. Non-specific pain accounts for around 90% of low back pain cases (World Health Organisation, 2023). Because most cases are non-specific, the myths covered here are related to non-specific pain. That is, pain that is NOT caused by a specific disease or injury.

The first myth of low back pain is that “pain means there is serious damage to the spine”. The possibility of serious damage can be a concern for many people because back pain can be very painful or persistent. This means it can be quite worrying and a common thought is that there is serious damage to the spine. Actually, research shows that only 1% of all back pain is related to a serious condition such as cancer, fracture, or infection (Pain-Ed, 2017). In most cases, pain does not mean there is serious pathology. Having this understanding is foundational to the management of back pain because it can help to reduce fear in thinking that the spine is seriously damaged. Of course, to rule out serious damage, a medical or health care professional are best placed to complete an assessment. 

The second myth is that “fixing the spine will stop the pain”. Often, a person with low back pain will have had have a scan such as an X-ray, CT, or MRI during the assessment process which shows changes to anatomical structures such as intervertebral disc’s and facet joints. The natural conclusion to make is that the pain experienced is the result of the changes seen on the scan and in order to reduce pain and regain function these structures should be fixed. However, in most cases there is not a good correlation between the pain experienced and anatomical changes seen on scans. This means it is less about the anatomy shown on the scan and more about the experience of pain and function.

Understanding that anatomical differences seen on scans may not accurately reflect the experience of pain and function is positive because it means in many cases, despite what the scan shows it is possible to reduce pain and improve function without changing the anatomy of the spine through surgery. This is not to minimise the situations where surgery is appropriate, however it does mean in most cases there are more treatment options available for those wishing to reduce pain and improve function.

The third myth is that “It's dangerous to exercise, bend, and lift.” Normal reactions to pain include protecting the painful area, guarding it, and keeping still. Think a fractured wrist. This is a natural reaction to prevent more pain, more damage, and more suffering. It therefore seems to make sense that we have the same protection reaction for low back pain, aiming to prevent more pain, damage, or suffering. Protective reactions may include resting in bed, reducing regular activities like housework, and avoiding exercise like walking.

While protection can be a normal reaction to pain, for pain that is not acute or specific in nature, including chronic non-specific low back pain, over time protective reactions can lead to negative outcomes such as physical deconditioning, withdrawal from life roles, and low mood. Understanding protection reactions is important in order to notice the reactions as they occur. With this insight, it becomes easier to shift toward more proactive management strategies, such as starting or continuing exercise and regaining normal movement patterns.

This article covered the difference between acute and chronic pain, specific and non-specific pain, and three common myths of low back pain. You have learned that pain does not usually mean there is serious damage to the spine, that fixing the spine through surgery may not solve the problem of pain, and how to identify protective reactions to pain. Understanding these concepts is foundational in order to reduce fear and anxiety around the nature of low back pain and ultimately for the successful management of low back pain. Of course, if you are unclear about the nature of your back pain it is important to seek advice from a medical or health care professional through a consultation.

I hope this article has been helpful. If you would like to refer back to the myths within this article, the accompanying video Low Back Pain Relief Exercise Rouitne + 3 Low Back Pain Myths can be found on the Age Fit with Tess YouTube Channel.

Low back pain. (2023, June 19). Www.who.int. https://www.who.int/news-room/fact-sheets/detail/low-back-pain#:~:text=Key%20facts

Pain-Ed. (2017, April 12). 10 facts about back pain — Pain-Ed. Www.pain-Ed.com. https://www.pain-ed.com/blog/2017/04/12/10-facts-about-back-pain/