Myths about low back pain
Myth #1 - Low back pain (LBP) is an old person’s problem
FACT - 85% of the population will experience LBP at some stage of their life – regardless of how many candles were on your last birthday cake. I explain to my clients that it is more often a matter of “when, not if” and there is never one single reason for LBP, but rather several contributing factors. It’s a physiotherapists job to identify these and address them accordingly.
Myth #2 – Strength will protect your back
FACT – Obtaining or maintaining strong ‘core’ muscles does help prevent LBP, but before you strengthen what is weak, you must re-educate what is inhibited and stretch what is tight.
Myth #3 – An MRI or other image is required to diagnose my LBP
FACT – A successful treatment plan can be based on a thorough medical Hx (history) and a physical examination. Most imaging will display problems that may not be generating any pain. As such, we need to treat the person, not the scan. Typically, I will only refer for further imaging if the patient is not progressing as expected and looks like they will need to visit a specialist.
Myth #4 – Sit-ups are safe & will strengthen my back
FACT – Traditional sit-ups use more of the hip flexor muscles. Tight hip flexors can place an excess load on the lumbar spine. In addition to this, sit-ups bring the lower spine into flexion which puts an increased load onto the disk. In fact, a recent study of intervertebral disk pressure showed that performing traditional sit-ups exceeded the recommend safe loading limit for occupational health and safety.
Myth #5 – Increased flexibility is beneficial
FACT – When seeing patients with LBP, I like to break them down into what I call ‘stiffies’ and ‘floppies’. ‘Stiffies’ tend to be short and stocky and will benefit from a good stretching program to manage their LBP. On the other hand, ‘floppies’ tend to be tall and lanky with increased joint hypermobility. This demographic requires a specific strengthening program ‘to hold everything in place’.
Myth #6 – Rest is the key to recovery from LBP
FACT – Bed rest and lounging around on the couch will only lead to increased pain and a slower recovery. Walking and gentle activity is strongly recommended. While it is important not to aggravate the injury, we need to find a delicate balance between keeping active and not overdoing it.
Justin Mistry MPhty / BExSc, APAM (Physio) is the Director of Back In Motion Bundall and Burleigh Waters. He has a passion for the management and rehabilitation of LBP and neck pain. He freely gives his time to educate other health professionals and the general community on the role of physiotherapy in achieving great health. He’s also won Back In Motion’s Most Inspirational Practice Director 2017 and 2018 as well as the Gold Coast Business Excellence Award – Health & Wellbeing category, August 2018