FACT: Roughly 80% of Americans will experience low back dysfunction in their lifetime. Also true is that approximately 80% of those individuals will experience recurring back pain. That means that about 65% of the population may experience ongoing back pain. There is good news, however. This statistic does not have to be true for you.
Because of many swirling myths and outright lies about low back pain, there is a higher prevalence of low back pain in society. As mentioned and worth repeating, this does not have to happen to you.
Spending well over 2 decades to gain knowledge and expertise on the spine has led us to be able share some plain and simple truths about the back. If you read and heed the words, you will be equipped to navigate the health of your low back cost-effectively, simply and with far less pain.
One major caution when it comes to your back is knowing that even well-meaning, so-called experts can mislead you with how to care for it. Let’s debunk those misleading opinions here.
Myth #1: Narcotics, surgery, or expensive injections are inevitable for low back or leg pain.
FACT: Contrary to what you may have read or been told about how to treat your back, 75-80% of all low back cases do not need addictive narcotics, injections or surgery to be healed completely. In fact, they can be more damaging to you if not prescribed expertly.
In a powerful study where over 900 individuals with back and leg pain were bound for surgery, 75% – 80% were able to avoid surgery by performing high-skilled mechanical therapy instead. Even after 5 years, these individuals showed no signs of recurring pain or functional loss. Skilled physical therapy by a certified mechanical therapist is an ideal first-line treatment for low back pain with or without leg pain.
Myth #2: My back went out so I need someone to “put it back in”.
FACT: First of all, joints that pop are commonly occurring due to cavitation of synovial joints (joints like the knee, shoulder or certain joints in the back). Let’s set the record straight here. If your practitioner tells you your back is out of alignment and needs popped back in, you should consider running out of their office as quickly as you are able. A spine that is truly out of alignment should be stabilized, not mobilized with manipulations. This subject deserves an entire article in and of itself and will be forthcoming.
A good doctor of physical therapy can distinguish if you have spinal slippage (“spondylo”) and recommend you to a surgeon in the rare case that your back is actually “out” of alignment. Most of the time people are told their back is out, it isn’t. You can have displacement of soft tissue, which may make it feel like your back is out, or appear on X-ray to be out of alignment. Again, a trustworthy practitioner, trained in mechanical therapy and diagnostics can assist you in knowing what the appropriate steps are for your spine healing.
In contrast to “popping the back in”, therapeutic exercise is a powerful and credible intervention to heal low back issues short and long-term. Multiple studies have showed that exercise is proven to be more effective than manipulation (only 10% of low back cases require manipulation). An ideal practitioner can both manipulate the spine when needed and perform upper level therapeutic exercises with you.
Myth #3: Just do knees to chest exercises or sit in a chair and bend forward to ease back pain.
FACT: Knee to chest or forward flexion exercises sadly get prescribed or suggested by some practitioners. I recently read a local article swirling around social media recommending these as first line low back exercises. The article was not founded in any research or clinical soundness. Do not be fooled into performing knee to chest exercises without some level of caution when your back hurts.
While flexion (bending forward) exercises of the spine are good for a select few injured individuals, they can actually damage your low back condition significantly and slow healing. Flexion exercises in a healthy spine are great if paired with extension exercises, but we are referring to impaired low backs here.
Knee to chest exercises may even feel good temporarily because you are opening an area of the spine that lets the nerves breathe a bit, but eventually this can move even more material from the spine onto the nerves. As a general rule of thumb, if it feels better temporarily but seems to hurt worse 20-30 minutes after performing knees to chest exercise, it is best you stop and call a Cert. MDT certified doctor of physical therapy. This one exercise should NEVER be a blanket recommendation for those with low back pain, especially not as a stand alone exercise.
Myth #4: My back pain is caused by arthritis or degenerative disc disease.
FACT: Degenerative discs (DDD) are common, like grey hairs on the head. Just because your MRI or other image shows degeneration does not mean what is visually seen is the cause of your back pain. This is important to understand if you wish to be successful. Correlation does not equal causation. In other words, if you have back pain and there are degenerative discs on an arthrogram, it does not automatically mean the pain is caused by what the image shows. In one prominent study, back pain actually was lower in the cohort of patients that had increased amounts of DDD on MRI.
MRIs can show false positives and negatives, meaning you could have issues the MRI neither picks up nor shows the true picture of. I have met far too many people who struggle with low back pain that believe they are subject to having the pain the rest of their lives because the MRI didn’t show anything or showed something too severe to fix. The low back is remarkable at healing if given the right strategy. Never succumb to the idea that because an MRI doesn’t show damage or the opposite, that you are not healable.
Myth #5: You should rest and avoid activity if you are experiencing low back pain.
FACT: YOU SHOULD NOT AVOID ACTIVITY IF YOU HAVE LOW BACK PAIN! Excessive rest is catabolic (causes us to waste away) to the muscles, joints and ligaments of our body. While some rest is good to protect the spine, introducing gradual and safe movements back into your life is critical to your success. It is recommended to exercise and get active and mobile as soon as possible after back injury or recognizing back pain.
We understand how difficult it can be to navigate low back pain. We are here to answer questions as they come for that reason. Because of the importance of skillfully knowing how to heal low back pain appropriately, all Wright Physical Therapy doctors of physical therapy are trained at highest levels of orthopedic specialty as well as mechanical diagnosis and therapy. Please call us at your local Wright Physical Therapy as found on wrightpt.com and we will put you in touch with one of our doctors to get answers.