I love backs – and I want you to start loving them too!

I think for too long our low back have been spoken of in a negative light, and I want that to change!

It’s time to start showing your back some love ❤️!

Now, it is true, back pain is quite common (80% of people will experience back pain in their lifetime) – BUT, back pain does not have to cascade into something big, particularly if we show our back some love in the early stages of back pain occurring!

To allow you to show your back some love, I’d like you to teach you some things about your back and also, I want to set straight some common misconceptions about your low back – particularly misconceptions about when back pain occurs!

So here are the 6 big things I want you to know about this awesome structure that is your back!

Your back is a very strong, stable structure!

    • It is actually very hard to cause a structural injury to your back
    • There is a lot of talk about backs that makes them out to be vulnerable and should be protected, this is untrue.
    • Our back are strong and are made to move and load! So move them (this includes flexing/bending!)
    • Most of the time when a back is sore it’s just a bit sensitized or a very mild strain
    • Strains usually resolve in under 6 weeks
    • Pain can happen in your back without any damage – usually it’s just a sensitivity/irritation!

Movement is medicine!

    • Both when back pain occurs and to prevent it from occurring movement is a key part of the puzzle
    • Far too often people stay still when back pain occurs, this actually is detrimental as it makes your brain think that movement is threatening…moving decreases this threat level!
    • Staying strong and mobile though your whole body, especially your back and hips, significantly reduces your risk of back pain
      • This occurs because your body and brain have a high level of confidence to get into many positions and produce force in these positions (including flexion)
      • NOT because your back in now “stable”
    • There’s lots of ways to find this strength, mobility and confidence – Pilates, yoga and gym are just a few

Words matter

    • The language we use about our back (and any part of our body really) affects our experience of pain and also how likely we are to have pain start or return
    • This is the language we use about our own back, the language our friends and family use and that our doctors/physios/chiros/surgeon
    • When we use word such as “my back is stuffed”, “I have the back of an 80-year-old”, “my back is out”, “it’s bone on bone”
      • Using language like this makes the brain think that our back is vulnerable and threatening therefore you’re more likely to have pain
    • While we’re at it – you’re back doesn’t go “out” and disc NEVER slip…..nope, never – if it went out then you would literally not be able to walk
    • So, show your back some verbal love! Tell it that it’s strong and stable and you love it for all it does for you!!

You very, very rarely need a scan

    • A scan should really only be done in extreme cases such as loss of strength or sensation in legs, changes to bladder and bowel function or if your therapist suspects something more sinister (e.g. cancer)
      • Keep in mind, these situations are a very small percentage of back pain
    • Scans will often show up changes of spinal structures that are actually completely normal
      • This then causes the pain to be attributed to structural changes of the spine that are actually quite normal
    • To highlight this, a systematic review by Brinjikji et al in 2014, looked at over 3,100 people without low back pain, each of these people were scanned and the images showed the following;
      • Disc degeneration was show in 37% of people in their 20’s, this went up to 96% of people in their 80s
      • Disc bulges – 30% of those in their 20’s to 84% of those in their 80’s
  • What this means is this – you can have scan findings that would be considered “pathological”, but have no pain…SO, when you have the same findings and pain along with it, it can mean the “pathology” often isn’t the cause of the main – there are other areas we can look at!
  • Note: I am not saying that pathological finding on a scan definitely won’t be the cause of the pain, but they shouldn’t be the thing we “hang our hat on”.

 

Non-physical lifestyle factors can have a big impact on your back pain

    • We term these factors “psycho-social” factors
    • Psychosocial (PS) factors affect your pain because all pain is produced by your brain
      • PS factors “hype up” your central nervous system (your brain), and therefore make it more likely to produce pain
    • PS factors include, but are not limited too
      • Stress (e.g. work or family stress)
      • Emotions and moods (low mood and depression are linked to back pain)
      • Sleep (poor or reduced amount)
      • Pain beliefs (e.g. The belief that pain = damage)
      • Expectations of pain
          • A classic example of this is having had a family member that has had issues with their back, therefore you expect you’re going to have issues with your back

Passive therapies should only play a small part in your rehabilitation

    • Examples of these are massage, mobilisation, manipulation, taping, ultrasound, heat packs, tens machines
    • These approaches only give temporary relief from pain and can be very helpful in the early stages of rehab to get you moving rehab
    • The majority of your rehab should be looking at the factors already discussed
        • Keeping moving – strength, mobility and varied movement
        • Addressing those PS factors – sleeping well and stress reduction
        • And speaking positively about your back!

 

So, there you have it, the 6 big things I want you to know about your back, which will allow you to start loving your back as much as I do!

If back pain does come along, please don’t hesitate to see your health care professional at Move Clinics, who will help empower you to move in the right direction!

 

About the Author: Reece Noble is one of our lead physiotherapists at Move, he has 8 years-experience as a physiotherapist and post graduate qualifications in exercise therapies and pain management.