Common myths and facts about low back pain

By Physiotherapist Zoe Shea (Back Physio in Nedlands)

Do you think that your low back pain (LBP) is caused by tissue damage or degeneration? Have you ever wondered if scans are needed? LBP has affected as much as nearly 10% of the global population but how well do we understand LBP?

Low back pain which is not caused by specific structural change, inflammation or diseases is classified as non-specific LBP. This is the most common type of LBP which is about 90% of all cases. Unhelpful LBP beliefs is one of the biggest factors that leads to ongoing LBP. They may result in less effective pain coping skills, low confidence to exercise and eventually leading to a viscous cycle of pain. In long term, these unhelpful beliefs result in persistent LBP and may increase the risk of impaired mental health e.g. increase stress and anxiety etc. As a result, it is important to identify misconceptions and develop a positive attitude to tackle LBP.

Research has showed that people are more likely to suffer from persistent LBP with unhelpful pain beliefs. Not only these beliefs won’t help to improve your LBP, but they will reinforce the negative attitudes and pain coping strategies such as avoidance behaviours and impaired motor and postural control.

Common unhelpful beliefs include:

  • Persistent LBP is always related to tissue damage
  • Scans are always needed to find the cause of LBP
  • I should stop anything that hurts my back
  • I have sore back because of poor posture and weak core

Facts about LBP:

  • Persistent LBP rarely associated with serious tissue damage
  • Scans rarely show the causes of LBP
  • Pain with exercise and movement does not equals harm
  • LBP is not caused by bad posture and weak core

Many of us may think that LBP is always associated with tissue damage or spine deterioration. However, there are a lot of factors that can cause LBP and pain does not necessarily mean that your back is damaged. In addition, to find the cause to your LBP does not always require medical imaging such as MRIs, CTs, X-rays, unless serious spinal pathology is suspected. Research shows that symptoms we experience may not correlate with scan findings. Most of the LBP can be improved effectively with conservative treatment involving pain education, activity modification, improving movement patterns and active exercise. Effective long-term management also involves self-management such as how to manage flare-ups and pacing activities. As physiotherapists we will assist you and help you to move in a safe and better way.

Ways we help to achieve the best care for managing persistent LBP,

Build a positive mindset😊

It is important to identify unhelpful beliefs as they directly affect how our body moves. Pain does not always equal to harm, our back does not wear out with just loading and bending! It could only mean our body is not used to that movement because we have been avoiding for a long time. So don’t stop moving just because you feel sore. Having a better knowledge about LBP enables you to build confidence in moving and staying active.

Improve movement patterns

Our bodies move in different ways. The underlying reasons for LBP may not only be biomechanical but also neuromuscular in nature. We identify unfavourable movement patterns which may drive LBP. Functional movements such as sit to stand, squats, bending forwards and lifting are common ones that we assess. By learning the correct patterns, strengthening and/or relaxing the appropriate muscle groups, your body will move better with less or even no pain.

Self-management strategies

Knowing how to manage flare-ups can be challenging. A sudden change in load may cause pain flare therefore pacing yourself is crucial. Ways to manage flare-ups includes setting achievable goals, modifying activities etc. You will learn how and when to progress/regress your exercises (including frequency and intensity) and be confident to move in a safe way. We will set a management plan for you to empower yourself in building strength and tolerance to exercise. It is also important to know when to get in touch if things do not go well.

Stay active and get your body stronger

Lastly it is to get your body fitter and stronger! It does not matter if it is doing your home exercise program, strengthening at the gym or attending physio-supervised Clinical Pilates classes, we will assist you to find the safest, the best (and fun!) way to build your physical capacity and develop habit of exercise.

To see our back physios in Nedlands, call our clinic on (08) 6389 2947.