Back Pain – Myths and Reality


Myth: Back Pain and Back Problems Won’t Happen to Me

Fact: Approximately eight out of ten people will experience back pain at some point in their lifetime. In the United States, back pain is:

  • The leading cause of disability in men over 45 years old
  • The second most common reason for a visit to a primary care doctor
  • The third most frequent reason for surgical procedures
  • The fifth most frequent cause of hospitalization.

So, unfortunately, the fact is that most people do experience back pain and back problems at some point in their lives.

Myth: Bad Back Pain Can Result in Paralysis

Fact: The spinal cord ends in the upper part of the low back (lumbar 1). Further down the low back there are only nerve roots, which are very tough structures. In most cases, a great deal of back pain does not usually indicate a back problem that could lead to paralysis. Examples of rare cases where paralysis may be a risk include spine tumors, spinal infections and unstable spine fractures.

Myth: Severe Back Pain Correlates to the Level of Back Damage

Fact: With acute pain, the level of pain correlates to the level of damage (e.g. if you touch a hot iron, you will immediately feel a great deal of pain). However, with chronic back pain (greater than 6 weeks), the amount of pain does not typically correlate the amount of damage.

Myth: I’m Physically Active, So I Shouldn’t Get Back Pain

Fact: While it’s true that well-conditioned individuals are less likely to have an episode of back pain than sedentary individuals, back pain can affect all people regardless of the level of activity. Some sports are more likely to cause back pain, such as golf, volleyball and gymnastics. In all cases, however, the back should be considered a priority in conditioning, because it creates a stable platform from which the arms and legs work.

Myth: The spine is delicate and easily injured.

Fact: The spine and its surrounding muscles, tendons and ligaments comprise a well-designed structure that’s incredibly strong, flexible and supportive. To help maintain the back and spine, proper conditioning is needed – including strengthening, flexibility and aerobic conditioning. While there are some exceptions to the rule (such as an unstable spinal fracture), the back does not need to be overprotected after recovering from a typical episode of back pain.

Myth: If I have back pain and back problems when I am young, it will get worse as I age.

Fact: The incidence of back pain is actually highest between the ages of 35 and 55. After age 55, people usually have less pain – especially discogenic pain (back pain or other pain or symptoms caused by disc problems). While disc degeneration is a natural part of the aging process, it is not always accompanied by pain.

Myth: My father (or mother) had bad back pain and back problems so I’m likely to have it.

Fact: For the vast majority of conditions related to back and neck pain, there is no genetic predisposition, which means that parents do not pass their back conditions onto their children.

Myth: An MRI scan or other diagnostic test is needed to diagnose my back problem.

Fact: Most health professionals can develop a successful treatment approach based on a thorough medical history and physical examination. Only specific symptom patterns in a minority of cases indicate the need for an MRI scan or other sophisticated tests. Typically, an MRI scan is used when patients are not responding to appropriate back pain treatment.

Myth: The abnormality/back problem on my MRI scan needs to be cured.

Fact: An abnormality that is seen on an imaging test (MRI, CT scan) does not necessarily cause back pain or other symptoms. In fact, the vast majority of people who never have had an episode of low back pain will have abnormalities (such as a herniated disc or degenerative disc) on an imaging test. For patients experiencing low back pain, 92%-96% can be treated successfully without back surgery.

Myth: If no specific back problem is found, my pain must be psychological.

Fact: Most cases of back pain will not follow the typical medical approach of specific structural diagnosis and remedy, but the pain is still real. While psychological factors, such as depression and sleeplessness will often need to be included as part of a comprehensive treatment program for back pain, there are also a variety of nonsurgical care options that can help alleviate the back pain. Additionally, persistent back pain symptoms should be investigated by a qualified spine specialist to rule out serious problems such as tumor or infection.

Myth #1: There is a standard “cure” for most causes of back and neck pain.

Fact: Compared to other medical conditions, there are relatively few standardized approaches to diagnosis and treatment of back problems. Spine specialists from various areas of expertise (such as physical medicine and rehabilitation, chiropractic, osteopathic medicine, physical therapy and surgery) will often disagree on the diagnosis and most appropriate treatment plan for back pain and back problems, and specialists within a discipline will also frequently have different opinions. A few diagnoses for back pain as a result of back a back problem are relatively straightforward (such as a spinal tumor, infection, or fracture) and there is generally more consensus for diagnosis and treatment of these back problems.

Myth #2: Rest is the key to recovery from back pain and back problems.

Fact: The two main reasons bed rest may be recommended for back pain are to reduce pressure on the discs in the spine and to stop the mechanical stresses that are irritating pain receptors. A short period of bed rest may help reduce acute back pain. However, in most instances, more than 1 or 2 days of rest can be detrimental to recovery from back pain, potentially leading to increased pain and other adverse results, such as:

  • Muscle atrophy (1% to 1.5% per day)
  • Cardiopulmonary deconditioning (15% loss in 10 days)
  • Bone mineral loss
  • Risk of blood clots
  • Loss of wages
  • Creating an “illness” mindset.

With that considered, a program of lower back exercises may help limit back pain.

Myth #3: Heat and massage feel good so they must be helping back pain and back problems.

Fact: These therapies can reduce acute back pain in the short-term, but do not provide a long-term solution to back problems. They are used to manage pain during recovery, allowing patients to complete a rehabilitation program and participate in daily activities.

Myth #4: Long-term pain indicates I need back surgery for my back problems.

Fact: Spine surgery actually has a reduced likelihood of being successful when treating chronic back pain.Typically, back pain symptoms that suggest back surgery might be helpful if they occur early in the course of pain and are relatively apparent.


The Myths and Reality of Back Pain