Low Back Pain Myths, Truths, and How-Tos: A Physiotherapist's Guide
Understanding Low Back Pain
Low back pain is one of the most common and frustrating ailments, and it's something that almost everyone will experience at some point in their lives. However, many misconceptions and myths surround low back pain, which can make it more difficult to effectively manage. In this blog, we’ll dive into some of the most common myths, the truths behind them, and offer practical steps on how to manage and overcome low back pain.
Myths About Low Back Pain
Myth #1: Low Back Pain Means Something Serious is Wrong
Truth: The majority of low back pain is not medically serious. Most cases of low back pain improve within 6-8 weeks without the need for medical intervention. While the pain can be debilitating, it usually doesn’t indicate a severe underlying medical issue.
Myth #2: There’s Always One Cause for My Low Back Pain
Truth: Low back pain is often a multifactorial issue, meaning several factors contribute to its onset. These factors can include physical load, stress, sleep, nutrition, past injuries, and even worries about your pain. Everyone's situation is unique, which is why personalized care is so important.
Myth #3: Imaging is Necessary to Treat Low Back Pain
Truth: Most low back pain does not require imaging (such as X-rays or MRIs). While imaging can be helpful in identifying certain issues, it often doesn't change the course of treatment. Physiotherapists can assess and treat many types of low back pain without the need for imaging.
Myth #4: A Disc Bulge Means I’m Doomed to Have Pain Forever
Truth: Disc bulges are common, even in people without pain. Studies show that disc bulges are present in 30-37% of 20-year-olds and as high as 96% of 80-year-olds, many of whom report no pain. Having a disc bulge doesn’t mean you will experience pain, and it doesn’t necessarily mean you’re doomed to chronic issues.
Myth #5: Exercise is Dangerous for My Lower Back
Truth: Low back pain is more common than not, but exercise, when done correctly, can be a powerful tool for managing pain. It’s not the exercise itself that causes harm—it’s poor technique or overloading the body too quickly. Gradual, controlled movements and proper programming are key.
The Truth About Low Back Pain: Sensitivity Over Damage
Pain doesn’t always equate to damage. In fact, low back pain is often more about sensitivity than actual tissue damage. Think of it like a sunburn—while the skin may hurt the day after as you shower, it doesn’t mean the burn is getting worse. Your skin is just more sensitive to the water. Your body can become more sensitive to certain movements and activities, even when no new damage is occurring.
Two Factors Contributing to Low Back Pain Sensitivity:
Physical Load: The volume, intensity, frequency, and technique of movement all influence your back’s sensitivity. Gradual loading and avoiding sudden, intense movements help prevent flare-ups.
Psychological Load: Stress, worries, and negative beliefs about pain can make your low back pain feel worse. Managing stress and addressing emotional factors can significantly help in reducing pain sensitivity.
Understanding Pain Sensitivity
When your low back pain becomes more sensitive, your body’s "tolerance" to movement and activity decreases. However, this doesn’t mean there’s tissue damage. The body is just more "alarm-reactive" to movements, and the key is to gently build that tolerance back up.
How to Manage Low Back Pain: Step-by-Step Guide
Managing low back pain is a gradual process that requires patience and persistence. There is no one-size-fits-all solution, but the following principles can help:
Step 1: Calm It Down
Focus on movement that is less painful or feels good. This helps reduce pain and sensitivity. If forward bending causes pain, try movements that encourage extension, such as cat-cow stretches or prone extensions.
Modify activities that exacerbate pain—take breaks from sitting or use lumbar support.
Step 2: Build It Up
Gradual exposure to activity is key. Start with gentle movements and slowly increase the intensity or duration of your movements. This "habituation" process allows your body to adapt to the stress and decrease sensitivity.
Green Zone (0-3/10 pain): Safe to progress.
Yellow Zone (4-6/10 pain): Monitor, but can continue with caution.
Red Zone (7-10/10 pain): Stop and modify load.
Step 3: Bridge the Gap
This phase focuses on returning to normal activities. Whether it’s lifting heavy weights at the gym or gardening for extended periods, it’s crucial to gradually prepare your body to meet the demands of your regular activities.
Understand that this process can take time and may involve trial and error.
Conclusion: Taking Control of Your Low Back Pain
Low back pain doesn’t have to be a lifelong burden. Understanding the myths and truths about low back pain, and following a structured approach to managing it, can help you regain control over your health. By focusing on both physical and psychological factors, and following the steps outlined above, you can reduce sensitivity and build a stronger, more resilient back.
If you’re struggling with low back pain and feel unsure about where to start, don’t hesitate to reach out to our team of physiotherapist.
They can help guide you through the rehab process and help you regain the confidence to do what you love.
