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10 Myths of persistent lower back pain

Dr Rangan Chatterjee recently interviewed Prof Peter O'Sullivan, a pain scientist and physiotherapist, on the topic of "How to break free from chronic pain and reclaim your life". You can listen to his interview on his podcast "Feel better, live more" Ep 472. This is a must listen to for anyone in chronic/persistent pain as I know it will help them. They are speaking my language of pain and I'm delighted that here we have 2 high profile Dr/scientists talking about this topic. They talk about the 10 myths of pain and I summarise them here with my own take on them. If you would like to know more about what you can do to manage your pain, then please get in touch as the BEAT pain methodology gives you the education and the tools to overcome your pain based on this science.

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Myth 1 : Lower back pain is usually a serious medical condition – in fact only 1% of back pain is linked with a serious condition.  We can rule these out very quickly or signpost you towards medical treatment if needed.

Myth 2 : Lower back pain will become persistent and deteriorate in later life – This simply isn’t true. When shown a scan showing deterioration of your spine, it is easy to believe this, but know that even asymptomatic (no pain) people will show spinal and joint degeneration because this is a normal sign of ageing. One of the most important factors in your recovery from chronic pain is ‘hope’ and many many of my clients including myself have overcome chronic pain.

Myth 3 : Persistent lower back pain is always related to tissue damage – Pain comes from a multitude of factors including biological factors (tissue damage) but also psychological and sociological factors too. Tissue damage may have triggered pain, but the body is very good at healing and your persistent pain is due to other factors.

Myth 4 : Scans are always needed to detect the cause of lower back pain – Scans only show part of the picture of pain (the physical one). Disc degeneration, disc bulges, dehydrated discs etc all happen in asymptomatic people and are a normal sign of ageing. Seeing scans can induce fear and catastrophization which can contribute to further pain. It rather depends on the language used by the consultant describing the scan to you.

Myth 5 : Pain related to exercise and movement is always a warning that harm is being done to the spine and a signal to stop or modify activity – Pain related to movement / exercise can be due to a well trodden neural pathway. These neural pathways can change. The spine loves and needs movement to heal.

Myth 6 : Lower back pain is caused by poor posture when sitting, standing and lifting – Pain can be a response to our belief patterns and if we believe that pain is triggered by a posture, poor driving position, bad mattress etc then it is more likely to trigger pain to protect you.

Myth 7 : Lower back pain is caused by weak ‘core’ muscles and having strong core protects against future pain – As a pilates instructor and back pain sufferer who has benefitted from Pilates, I struggled initially to understand this one. However, what they talk about on the podcast is that engaging core all the time is not natural, and it can inhibit our breathing which is not good for pain. Pilates teaches breathing whilst engaging core and is therefore beneficial for back pain sufferers.

Myth 8 : Repeated spinal loading results in ‘wear and tear’ and tissue damage – The spine loves loading and is designed for it. Discs are designed to be shock absorbers and that loading can help strengthen and repair discs. We are strong!

Myth 9 : Pain flare ups are a sign of tissue damage and require rest – A flare up is the body trying to tell you that something is up. It’s your body trying to get you to listen. Understanding pain gives you greater control and allows you to be a better listener of your body. Understanding pain empowers you to know what to do during a flare up. My BEAT pain program teaches you how to do this.

Myth 10 : Treatments such as strong medications, injections and surgery are effective and necessary to treat lower back pain – If your pain is not due to tissue damage (99% of chronic cases of back pain) then surgery and medication simply won’t work and can make things worse. Ask your Dr “what happens if I do nothing (no treatment)?”

Which myth most resonates with you?

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