Back Pain Myth Busters

In a feature on their website, the Chartered Society of Physiotherapy has dispelled some common myths about back pain, providing details of what the latest evidence says is best for your back.  Below are the main points from the feature.  To read it in full, including references to the research studies which back up the claims, click this link.

Myth One – Moving will make my back pain worse

Although it’s true that some movements can be uncomfortable when you have back pain, it is well-established that returning to movement and work as soon as you are able, is better than bed rest for aiding recovery and preventing recurrence.

This is not a new concept by any means, but the unfortunate misconception that rest is better than movement continues to endure, due in part to the complex nature of pain.

Myth Two – I should avoid exercise, especially weight training

Exercise is generally accepted amongst all respected authorities to be the best way of treating low back pain in both the acute and chronic phases.

Studies have shown great benefits of various types of exercise, including high load resistance training.

Interestingly, no one type of exercise proves to be better or worse, so simply do what you enjoy and can tolerate. Gradually build up as your confidence and ability improves.

Myth Three – A scan will tell me exactly what’s wrong

There is a large and growing body of research that shows that not only do results of scans correlate poorly with symptoms in people with Low Back Pain, but also that most people without Low Back Pain have changes on scans and x-rays that do not cause any symptoms at all.

For these reasons and more, imaging alone isn’t capable of telling us exactly why someone is experiencing pain.

Of course this does not mean that all MRI scans are irrelevant in all cases, but it does mean that they are not always necessary or helpful. In fact, there is evidence to suggest that in some cases, having a scan can make situations worse.

Myth Four – Pain equals damage

The level of pain experienced is very rarely proportional to the amount of injury sustained to the back. Pain is far more complex than this as pain levels are a reflection of how threatened a person perceives themselves to be. For example, past experience, general health factors, beliefs, sleep and exercise levels as well as psychological wellbeing, all play an important role in how much pain each individual might feel.

The above myth busters were developed by a working group of Chartered Society of Physiotherapy members comprising representatives of the Musculoskeletal Association of Chartered Physiotherapists, the Physiotherapy Pain Association, the consultants’ group and physios working in the NHS and the private sector.

To close, here’s Nils Frahm playing the piano with toilet brushes…no, really!  If you get the chance to see him live, grab it with both hands…

 

Stress and Back Pain

Stress

Having back pain can cause a great deal of stress for the sufferer, but what about the other way around? Could stress be a primary cause of back pain? Dr John Sarno, Professor of Rehabilitation Medicine, New York University School of Medicine believes the answer is yes. He has coined the phrase Tension Myositis Syndrome (TMS) to describe stress-related back pain.

The pain is not imaginary, rather the result of very real physical problems which are being impacted upon by emotional factors.

How does stress cause back pain?

Dr. Sarno’s theory is that patients who do not deal with their stress and anxiety, unconsciously push them out of their awareness and into their unconscious. This unconscious tension starts a cascade of changes in the body including:

  • Constriction of blood vessels throughout the body;
  • Reduction of blood flow to the muscles and other tissues of the body;
  • Decrease in oxygen in the muscles and tissues of the body;
  • Buildup of biochemical waste in the muscles.

This cascade of events then causes:

  • Muscle tension
  • Muscle spasms
  • Back pain

Back and neck pain

Diagnosing stress-related back pain

A thorough physical examination will rule out any serious spinal disorders or structural causes of pain such as a degenerative disc.

The symptoms of stress-related back pain are similar to fibromyalgia and include:

  • Back pain and/or neck pain
  • Diffuse muscle aches
  • Muscle tender points
  • Sleep disturbance and fatigue

In many stress-related back pain cases, patients complain of experiencing the pain from just “moving around”.

Stress ball

Treatments for stress-related back pain

The two most common ways to treat back pain caused by stress are the psychotherapeutic approach and the multi-disciplinary approach.

Through psychotherapy, the patient is encouraged to process the unconscious negative emotions, e.g. anger, fear etc, and acknowledge to themselves that the back pain is a result of unconscious issues.

Most doctors use the multi-disciplinary approach, which combines therapies and exercise disciplines like Pilates to address the physical, emotional, cognitive, and environmental issues the patient is dealing with.

Sand passing through a hand

Information source for this news item: Spine Health