Ten Back Pain facts
We've all had a niggly low back at some point and I bet you, like me, you began to think the worst.
My thoughts generally go something like this “It'll get so bad, I won't be able to teach yoga. I won't be able to earn a living. I won't be able to buy food. I'll have to cook my own liver to stay alive…”You get the gist.
So before our thoughts get out of hand, I thought it useful to look into back pain. (Though I did get a little lost researching 'why humans love to catastrophise?'* and 'can you eat your own liver?'**)
I found a 2019 British Journal of Sports Medicine article 'Back to basics: 10 facts every person should know about back pain' and am sharing it here, because 3/4 of people will suffer from back pain at some point in their lives.
1. Persistent back pain can be scary, but it is rarely dangerous.
It can be distressing and disabling, but rarely life threatening, and you're very unlikely to end up in a wheelchair.
2. Getting older is not a cause for back pain.
Although it's a widespread belief and concern that getting older causes or worsens back pain, research does not support this and evidence-based treatments can help at any age.
3. Persistent back pain is rarely associated with serious tissue damage.
Backs are strong if you have an injury, tissue healing occurs within three months. If pain persists past this time, it's usually means there are other contributing factors. A lot of back pain begins with no injury or with simple everyday movement. Contributing factors might be stress, tension, fatigue, inactivity, or unaccustomed activity which can make the back sensitive to movement and loading.
4. Scans rarely show the cause of back pain.
Scans are important, but only for a minority of people. Lots of scary sounding things can be reported on scans such as disc bulges, degeneration, arthritis, et cetera. These findings are very common in people without back pain, and that they don't predict how much pain you feel or how disabled you are. Scans also change and most disc prolapses shrink overtime.
5. Pain with exercise and movement doesn't mean you're doing harm.
When pain persists it's common that the spine and surrounding muscles become really sensitive to touch and with movement. The pain you feel during movements and activities reflect how sensitive your structures are, not how damaged you are. It's safe and normal to feel some pain when you start to move and exercise. This usually settles down with time as you get more active. In fact, exercise and movement are one of the most effective ways to treat back pain.
6. Back pain is not caused by poor posture.
A variety of postures are healthy for the back. It's safe to relax during everyday tasks such as sitting, bending, and lifting with around back.
7. Back pain is not caused by a weak core.
Core muscles do not cause back pain. In fact, people with back pain often tense their core muscles and stick their belly in during activities as a protective response. It is like clenching your fist after you've sprained your wrist. Being strong is important when you need the muscles to switch on, but being tense all the time isn't helpful. Learning to relax the core muscles during everyday tasks can be helpful.
8. Backs do not wear out with everyday loading and bending.
The same way lifting weights makes muscle stronger, moving a loading make the back stronger and healthier, so activities like running, twisting, bending and lifting are safe if you start gradually in practise regularly.
9. Pain flare ups don't mean you are damaging yourself.
While pain flare ups can be very painful and scary, they are not usually related to tissue damage. The common triggers are things like poor sleep, stress, tension worries, low mood, inactivity, unaccustomed activity. Controlling these factors can help prevent exacerbations, and if you have a pain flare up instead of treating it like an injury, try to stay calm, relax and keep moving.
10. Injection, surgery and strong drugs usually aren't a cure.
Spine injection surgery and strong drugs like opioids usually aren't effective for persistent back pain in the long term. They come with risks and can have unhelpful side effects. Finding low risk ways to put you in control over your pain is key.
(*It may have something to do with evolution and the fact that we used to live more dangerous and less socially organised lives... but that is for another newletter
** NO apart from the fact you would die- maybe laughing- it seems it's against the law too and doesn't taste very nice).
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