Lower back pain is amongst the most common conditions we see and treat as physiotherapists, where 70-90% of the Australian population is estimated to suffer from lower back pain at some point in their life. For most people, lower back pain has no mechanism of injury and people will report being ‘unsure of how they hurt themselves’.
It’s reported that 90% of cases are ‘non-specific’, meaning there is no definitive mechanism or damaged structure attributed to your pain, and the cause may remain unknown even after a full assessment. Being that lower back pain is so common and often, so debilitating, there are many misconceptions surrounding lower back pain that can actually delay your recovery. For example, most people will report that certain movements or activities, such as bending down to the floor or getting up from a chair, are uncomfortable. Therefore, patients will report that they avoid or modify these activities to prevent pain. This often stems from the belief that pain = damage, which isn’t always the case. Despite the desire to rest and avoid pain being a normal protective response in the early (acute) stages, these behaviors and beliefs can be harmful long term. Let’s talk about some common misconceptions:
Movement or exercise is bad when I have lower back pain:
Movement and exercise, for most, is encouraged and has been shown to help improve patient recovery and pain. Chances are, if you’ve ever presented to physiotherapy for management of lower back pain, you’ve been prescribed exercise for this very reason.
Pain = damage:
Many believe that pain is the body’s way of warning you that you’re doing further damage to injured structures, but this isn’t always true, and avoiding movement because you feel pain can be counterproductive and prolong your recovery. Exercise has been shown to desensitize the body from pain and help to strengthen your body.
My bulged disc is the cause of my pain:
Firstly, this may be the case for some people. However, scans don’t always correlate with your pain and may be an ‘incidental finding’. Essentially, this means that the bulged or slipped disc that was reported on your CT, may have been present before your pain began, and may continue to be present well after you have fully recovered.
My back will never be the same:
Those who suffer with lower back pain may hold the belief that even with treatment, their back will never be as strong, healthy or pain-free as it once was. Not only is this inaccurate according to research, but you would never hold this same belief for a sprained ankle. If you were to sprain your ankle or strain a muscle, you would never think “I’m never going to recover”, so why treat back pain any different.
Overall, more and more emerging research is supporting the re-introduction to exercise and movement throughout all stages of lower back treatment. There is strong evidence to suggest that exercise can desensitize you from pain, increase your strength and function, speed up your recovery, and even decrease your risk of re-injury if you maintain exercise long term. While, like all injuries, your treatment is based on your individualized circumstances, goals and diagnosis, exercise is likely to play a large role in your recovery.