the challenging facts about chronic back pain
Sponsored by Body Dynamics Illawarra
Fortunately, for nearly 90% of people, these complaints will be non-specific back pain, meaning there is nothing sinister causing their pain. Most of these complaints will come about from muscle weakness from too little exercise. Back pain can also be the result of doing too much when your body is not accustomed to an activity, such as heavy gardening or repetitive lifting causing physical fatigue, resulting in muscles spasm or strain.
The ways to treat and speak about back pain over the years has improved as we have become more knowledgeable about back pain and its causes. The most important thing regarding back pain is to understand what might be triggering it and, with guidance, keep moving.
Back pain can be scary and painful, especially when it appears to have no cause, is impacting your life and hanging around a long time. It can be hard to accept that you just have to ‘get on with it’ and sometimes it may feel that you are not able.
That is where it is important to seek guidance on pain management strategies such as safe movement and where to start. Our friendly team of Accredited Exercise Physiologists are here to help support clients to better understand and reduce fear about back pain.
1. Chronic back pain is rarely life threatening with less than 2% relating to a serious disease such as cancer. Chronic back pain is more likely a symptom of poor functional ability, which is linked to mortality risk than back pain itself.
2. Old age does not equate to back pain – more likely it is a symptom of deconditioning resulting from a reduction in activity
3. Chronic back pain rarely relates to serious disease or damage. Body tissue healing times vary yet are generally no more than 3 months. Research in chronic pain show many contributing factors that are more likely to lead to chronic pain, such as stress, fatigue, inactivity and poor pain coping behaviours.
4. A ‘scary’ scan does not predict the levels, severity nor the time frame of back pain. Post COVID lockdowns show many people reporting a reduction in activity and increases in pain. Most of their scans show changes that develop over a long period. There is evidence that shows across a general population that 80% of people with pathology on a scan of their back report NO pain.
5. Pain with movement does not mean you are doing harm. Movement of the spine in all directions can be safe and is necessary for a health spine. Long term pain is associated with a heightened sensitivity of our nervous system and does not relate to the severity of an injury.
6. Poor posture does not cause back pain. Our body’s create signals to get us moving, if you ignore these signals then you may have stiffness or soreness in certain postures, especially if they are prolonged. These postures are not the cause of lower back pain, albeit they may be painful.
7. A weak core does not cause back pain. Our core’s role is to regulate the pressure within our abdominal cavity. If a load is repetitive or is too heavy and we are not accustomed to it, then it is harder for ALL muscles to manage that load, not just your core. Learning to tensing your ‘core’ all the time is often not helpful for back pain.
8. Normal everyday bending and loading does not wear out our backs. Movement and loading are safe when implemented gradually and our muscles and other tissue have time to adapt to the load. In cases of metastatic bone cancer or osteoporosis then particular movements may need more caution.
9. Pain flare ups do not mean you have injured yourself or caused more damage. Flare ups are often related to things such as fatigue, stress, and changes to activity - either too much or too little).
10. Effective treatments are usually cost effective and non-invasive. Unfortunately, the old saying is often true, if it sounds too good to be true, then it is. Medications, injections and even surgery are often not effective for back pain long term. Other ‘quick fixes’ may help in the very short term, yet in many cases the pain returns quickly. The great news is that simple approaches can often provide the greatest long-term results and reduce risk of back pain returning. These approaches are graded exercise therapy, improved sleep, and maintaining a healthy social life. Pain education can be extremely helpful in chronic pain, along with counselling to promote a positive mindset.