Lower back pain is common...more common than the common cold. 8 out of every 10 people have had a back problem, or will have a back problem sometime in his or her life. Consequently, when it's your turn it seems as if everyone has an opinion and some advice to offer. Sometimes this unasked advice can be very helpful. On the other hand, sometimes this advice can actually be harmful, even damaging. Age-old wisdom about back pain abounds. Some of these so-called common sense notions have long since been discredited by research, observation and study.
In this article, I'd like to discuss the most common urban myths surrounding lower back difficulty. Much of my background information comes from Lippincott, Williams & Wilkins publication The BackLetter from the January 2004 edition. This edition sites a study from Norway in which over 1000 telephone surveys were conducted about beliefs of back pain. The results were surprising, only in the fact that these false opinions seem to live on.
The 7 most common wrong notions about low back pain are:
- Back pain is usually disabling.
- If your back hurts, you should rest until it goes away.
- Most back pain is caused from lifting.
- X-rays, MRI's and CT scans can always tell what's wrong with your back.
- Everyone with back pain should have an x-ray.
The main thing to do with a sore back is to rest in bed.
A good majority of those interviewed held these thoughts about back pain. Although this study involved random members of the Norwegian population, I suspect these views are quite universal. Many of these attitudes come from medical advice given to patients by their doctors 30 or 40 years ago. In spite of new thinking on these subjects, conventional wisdom dies hard.
It is amazing to me how much stock people put into x-rays and other imaging techniques, especially MRI. How can we get it across to patients that these modern gadgets, while very helpful with some disease states, are of minimal value when dealing with the common, garden variety lower back strain? By far the majority of back pains are functional in nature, not structural; therefore, pictures and images that look at bones and muscles (the structure) cannot possibly see problems in the way things move, and work in the spine. These advanced imaging methods are expensive, time-consuming and somewhat dangerous (particularly ionizing radiation). Waiting weeks and weeks for a CT or MRI while still in pain only serves to potentiate the problem getting worse and more chronic
