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7 Back Pain Myths To Stop Believing

And What To Know Instead
 Jun 7, 2018  15 min read

Back Pain Myth 1: Disc degeneration is a disease

 

MYTH 1: Disc degeneration is a disease.

 

You may not have heard of Degenerative Disk Disease, but the odds are you’ve heard about at least one of its cousins – Herniated Disc, Disc Bulge, Slipped Disc, Spinal Stenosis, Facet Joint Syndrome, or the scary tongue twister, Spondylolisthesis. What do they all have in common? They’re all NOT diseases. “Degenerative Disc Disease” is probably the most confusing – disease is right there in the name! But all of these terms describe conditions of the spine, not diseases.

Many patients are alarmed by a diagnosis with these terms. However, disc degeneration is a natural part of the aging process. Perhaps the medical terminology makes it more intimidating. For instance, you might also feel concern if your doctor diagnosed you with “ageing lines emanating from the lateral canthi of eyes” (crow’s feet) or “a rapid progression of canities” (grey hair). Both crow’s feet and greying hair are a natural part of the aging process, just like disc degeneration, yet only the latter causes alarm.

Of course, spinal and disc conditions can be related to pain or discomfort, due either to natural aging or to outside factors. However, many people have conditions like herniated discs and narrowing spinal columns, yet feel no associated pain (source). So even if you do experience pain, Degenerative Disc Disease may not be the cause, or at least not the only cause.

So how should you react to a diagnosis like this? The important thing to remember is that this is an expected condition for most of the population, and that many of your peers live pain-free even with such conditions (source). There are many treatments available for pain related to degenerative disc conditions, but if you feel no pain, you probably don’t need to seek them.

As we’ll discuss below, there are many conservative (non-invasive) ways to treat back pain, from exercise to an improved understanding of how your back works.

Back Pain Myth 2: Surgery is the most permanent option

MYTH 2: Surgery is the most permanent option.

 

While there’s nothing wrong with seeking back surgery if you need it, back surgery is a highly invasive and difficult procedure, and should only be considered as a last resort. If your doctor pushes you to get back surgery without trying less risky approaches first, get a second opinion!

You may also feel that surgery is a more permanent option that “fixes” the problem. However, for the majority of cases, back pain will go away on its own with proper rest or lifestyle changes (source). For more persistent cases, choosing surgery over more conservative approaches like physical therapy still doesn’t yield more long-term results (source).

Back Pain Myth 3: Your discs can slip

MYTH 3: Your discs can “slip.”

 

Ever been warned that your discs can slip? Or had a friend tell you their back pain all started with a slipped disc? While the idea of a slipped disc is pervasive in our society, it’s not actually a real thing. Discs don’t slip!

Vertebral discs act like cushions in between the vertebrae, or the bones that make up your spine. The discs are made up of a tough outer material with a gel-like fluid on the inside. Some docs compare it to a jelly donut. And we know what you’re thinking, “My spine’s made out of jelly donuts? No wonder my back hurts!” – but this is a donut that’s been specially engineered to withstand tremendous pressure.

Scientists studying the strength of vertebral discs found they could apply up to 720 lbs of pressure before discs even started to show strain (source). And that’s the disc’s strength by itself! Inside your body, your vertebral discs can count on the rest of your musculoskeletal structure to help carry the load. Not only are vertebral discs incredibly sturdy, they’re held in place by cartilaginous endplates located between the disc and the vertebrae. These endplates prevent the discs from slipping, ever (source).

So why is the idea of the slipped disc so common? Well, while discs don’t slip and slide around in your spine like Jenga blocks, they can be injured. A degenerated disc can bulge or even herniate, both of which can aggravate local nerves, causing pain and discomfort (source). But like other kinds of injuries, disc injuries can heal. Pain from disc issues like herniation will often go away on its own, as the number of proteins irritating the nerves decreases over time. It’s important to remember that even a herniated disc is a functional disc – it hasn’t slipped out of place!

Back Pain Myth 4: Pain is a sign of damage

MYTH 4: Pain is a sign of damage.

 

It makes sense to think of pain as an indicator of damage. When you get a papercut on your finger or skin your knee – ouch! – you feel pain because you’ve been hurt, right? Well, yes and no. We’re really just beginning to understand how pain works, and it’s not quite as simple as: x damage = x pain.

Pain is your brain’s way of looking out for you, and it’s more like a conversation between your body and brain than a one-way damage alert system. The level of pain you feel won’t always correlate to the level of tissue damage. You can feel severe pain for a minor injury, or your pain can feel insignificant even when an injury is severe. This is because your brain has a say in how much pain you experience and can modulate your pain level based on whether an activity seems safe or dangerous.

So what does this have to do with back pain? Are you just supposed to ignore pain because it’s “all in your head?” No, that’s not really fair to you or your brain! Pain is a real sensation that’s not directly under your control – this is your subconscious brain we’re talking about, after all – and as we’ve said, pain is your brain’s way of looking out for you. What’s important to understand is that your brain can be overprotective, and not all pain is a cause for immediate alarm.

And while you can’t ‘think the pain away,’ one thing you can control is your knowledge and expectations. If you assume your pain is a sure sign that something’s wrong, you may avoid normal daily activities that are actually good for your back, and your pain can get worse (source). On the other hand, if you know that your back is a strong and robust structure, those light exercises your PT recommended might seem a lot less intimidating. Fear and anxiety can have a huge influence on pain levels, and learning about your body’s anatomy can help reduce that fear.

The more you know about your pain, the more control you have over your recovery!

Back Pain Myth 5: An MRI Tells All

MYTH 5: An MRI tells all.

 

Medical imaging can tell us a lot about what’s happening inside our body, and can be hugely important in helping medical professionals determine diagnoses and appropriate treatments. But can it tell us everything? Like we’ve mentioned before, pain can be a wily thing to pin down, and in the case of back pain (especially lower back pain), an MRI can be more misleading than illuminating.

Take this study done on ‘asymptomatic’ patients (patients who reported experiencing no back pain) who were put through an MRI scanner. Though none of the patients had back pain, more than 87% had disc bulges (source).

As we discussed in Myth #1, the presence of disc bulges doesn’t always correlate with low back pain. So while costly medical imagining can show you whether or not you have a degenerating disc, it can’t tell you if that disc bulge is the cause of your pain. Save time and money by seeking conservative treatment for back pain first; your MRI may turn out to be an overpriced selfie!

Back Pain Myth 6: Rest is Best

MYTH 6: Rest is best.

 

Physicians have been recommending rest to treat pain for the better part of medical history. And while resting your body is a vital step in recovering from injury, surgery, and other conditions, there’s been some discussion in recent years surrounding how effective rest is for musculoskeletal pain.

What’s musculoskeletal pain? Your muscular system (muscles) and skeletal system (bones, cartilage, ligaments, and tendons) work together to give your body support, stability, and the ability to move. In other words, your musculoskeletal system is literally what gets you up in the morning! Most of the pain you experience on a daily basis is musculoskeletal: ie. when your knee hurts after a run, your shoulder cramps when you sleep on it funny, or your back is sore after standing up or setting down all day. When we look at treating lower back pain like other kinds of musculoskeletal pain, we find that rest isn’t always best (source, source).

In fact, the opposite may be true. Multiple studies have found that light exercise is more effective than rest for treating musculoskeletal pain. Appropriate stretching and exercise can help relieve: neck pain, shoulder pain, knee pain, and yep, lower back pain.

Back Pain Myth 7: You Can't Prevent Back Pain

MYTH 7: You can’t prevent back pain.

 

Back pain is one of the most common sources of pain for adult Americans, but it doesn’t have to be inevitable. In fact, the best treatment for back pain may actually be prevention!

But how can you prevent back pain before it happens? Unlike what your recent course on Ergonomics taught you, it’s not ‘lifting with your knees.’ One way that might surprise you? Weightlifting.

It’s counterintuitive – many of us believe that working our backs should cause pain, not prevent it. “Couldn’t I hurt my back doing that?” However, multiple studies have proved that exercise – specifically weight-bearing exercise – is safe for individuals with lower back pain (source). Not only that, participants in this free-weight exercise course overwhelmingly reported a decrease in back pain. So did participants in a different weight training program, where up to 80% had improved pain and ability two years after the program ended.

So why does weightlifting – or weight-bearing exercise – reduce back pain? And how does it prevent back pain? Both questions have the same answer: a stronger core and back are the key to a pain-free back (source). Back pain often stems from postural problems, where one muscle or group of muscles does more work than the rest. Strength training should focus on stabilizing muscles, and it’s not just your abs! The glutes, hamstrings, lats, etc. also provide vital support to your back and spine.

Of course, there are exceptions to who will benefit from strength training; every person and situation is unique. You should not, for example, engage in resistance training if you have a spinal fracture or tumor. You should always listen to your body – if an exercise causes you pain and not just soreness, you should stop.

A physical therapist can help you determine what exercises are safe for you, and what specific muscle groups you need to work to help prevent and treat back pain (hint: even if you think you’re exercising your core, you may be missing half of it!).

 

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We will accommodate reasonable requests. We may also condition this accommodation by asking you for information as to how payment will be handled or specification of an alternative address or other method of contact. We will not request an explanation from you as to the basis for the request. Please make this request in writing to our Privacy Officer.
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upon request, even if you have agreed to accept this notice electronically.
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You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our Privacy Officer of your complaint. We will not retaliate against you for filing a complaint

You may contact our Privacy Officer at (704) 824-7800 for further information about the complaint process.

This notice was published and becomes effective on August l, 2011.