Back Pain Myths

 

There are certain back pain myths, that many people assume are gospel. No exact and proven cause for spinal soreness has been established, although billions of dollars are being spent each year. There are some common claims which underlie the causes of back soreness, such as bulging discs, vertebrae fracture, stenosis, spinal curvatures, pelvic tilts, and leg length asymmetry according to this article. Lack of core strength is also attributed towards pain in the back, but none of these have been found to have established citations.

 

 

Dr Andrew Quaile, Consultant Spinal and Orthopaedic Surgeon and Medical Director of SpineWorks answers some common FAQ questions about myths related to back soreness.

 

 

 

Back Pain Myths

Misconceptions about back ache exist for both patients and doctors. Learn the more common misconceptions in this article.

95 percent of spinal cases (such as muscle spasms or a dull ache in the lower back) are what experts call non-specific. That means that the exact cause is usually elusive and cannot be attributable to an identifiable condition (such as infection, tumor, arthritis, or inflammation, which are specific cases, and the minority). With non-specific low back pain (LBP) being so common and so elusive, it has become a big business with Americans spending at over $50 billion each year on potential treatment and prevention strategies.

 

That can be a problem. Anytime you talk about an amount of money that large, you’re bound to attract experts – both legitimate and those who are, well, full of it – who claim they a) know the exact cause of your lower back pain, and b) have the cure for it.

 

You shouldn’t believe them – at least, not right away.

 

Common Claim #1: Bulging discs, vertebrae fracture, and stenosis cause back pain

 

BULGING DISCS: A landmark 1994 study in the New England Journal of Medicine found that 82 percent of study participants who were pain-free had positive MRI results for a lumbar disc bulge, protrusion, or extrusion. 38 percent of them had these issues at multiple lumbar levels.

 

A 2001 study in the Journal of Bone and Joint Surgery showed that MRI scans were not predictive of the development or duration of LBP and that individuals with the longest duration of low-back pain did not have the greatest degree of anatomical abnormality.

 

Common Claim #2: Spinal curvatures, pelvic tilts, or leg length asymmetry cause LBP

 

SPINAL CURVES: A 2008 review in the Journal of Manipulative and Physiological Therapeutics looked at more than 50 studies and found no association between measurements of spinal curves and pain.

 

According to Eyal Lederman, Ph.D., an osteopath and author of several manual therapy textbooks and research papers, “There is no correlation between pelvic obliquity/asymmetry and the lateral sacral base angle and LBP. But there may be an association between severe scoliosis and back pain.”

 

PELVIC TILT: Many health professionals believe that anterior pelvic tilt and increased lumbar lordosis indicate abdominal weakness and overly strong (or tight) hip flexors. But, according to a 2004 study in the Internet Journal of Allied Health Science and Practice, there is no relationship between lumbar lordosis and isometric strength of the trunk flexors, trunk extensors, and hip flexors and extensors. Several other studies have also had similar findings.

 

LEG LENGTH ASYMMETRY: According to Dr. Lederman, “Although some earlier studies suggest a correlation, more relevant are prospective studies in which no correlation was found between leg length inequality and LBP. Even patients who have acquired their leg length differences later in life as consequence of disease or surgery had a poor correlation between leg-length inequality, lumbar scoliosis and low-back disorders several years after the onset of the condition.”

 

THE TAKEAWAY: Many people with poor postural alignment or asymmetry have zero pain while others with better alignment suffer from chronic pain. So, automatically blaming these factors is misguided since physical imperfections seem to be normal variations, not pathology. As Mark Comerford, author of Kinetic Control: The Management of Uncontrolled Movement puts it, “There’s a big difference between dysfunction and simply a variation on normal.”

 

Common Claim #3: Lack of core stability (transverse abdominis weakness), or poor core strength causes LBP

 

CORE STABILITY: According to Comerford, “The Transverse Abdominis (TvA) has never been shown to be off or weak, even in patients with LBP. It’s only been shown to activate 50-90 milliseconds late only in people with LBP. We know through the research that the TvA timing delay is NOT the cause of the pain, but a symptom of it.”

 

Additionally, Stuart McGill, Ph.D. and professor of spine biomechanics at the University of Waterloo, says; “True spine stability is achieved with a balanced stiffening (co-contraction) of the entire trunk musculature, including the abdominals, the latissimusdorsi and the back extensors. Focusing on a single muscle generally results in less stability.”

 

CORE STRENGTH: According to Dr. McGill, “The differences between those with chronic, recurring back issues and matched asymptomatic controls,” or, people in the studies who have no pain, “have been shown to be variables other than strength or mobility.” In other words, in this research, core strength was not the cause of the sufferers’ pain.

 

THE TAKEAWAY: There’s no need, nor is it recommended to “draw in” your belly button during exercise or sporting activities. Core strengthening may or may not help you relieve or prevent LBP. As Comerford says, “If all back pain was due to weakness, than the strongest athletes in the world would never have pain, but they do.”

 

Read more here

 

 

Finding the exact cause of back pain in many cases is still often unknown. This situation is not acceptable to many sufferers. There have been cases where people have suffered back pain without any of the common causes. Research studies aim to dispel the back pain myths, and aim to find out the exact causes underlying most forms of back pain.

 

 

In this video Dr. Shane Burch from UCSF Department of Orthopaedic Surgery explores the spine and discusses the causes and management of back pain.

 

 

 

Dr. Garreth MacDonald, Chiropractic Physician from Cascade Health Center explains the “Do’s & Don’ts” of exercise and back pain and myths about back pain and exercises.

 

 

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