Common myths and misconceptions surrounding back pain
1. Stretch the pain away
It is a common misconception for individuals experiencing low back pain to attempt to alleviate their discomfort through stretching directly into the pain. For instance, if bending forward is painful or feels stiff, they often try to relieve it by stretching, such as reaching forward to touch their toes, pulling their knees up to their chest, or performing other stretches that round their back.
This is a bad idea in just about every situation. In most cases, when a specific movement causes pain or stiffness, it serves as a warning signal that the movement should be avoided, rather than pushed further into. Attempting to stretch away the pain typically only exacerbates it in the long term.
I have seen many patients who have been trying to stretch their pain away. In most cases, the stretches they were performing were contributing to their ongoing back pain. I cannot recall any examples where I recommended that they continue with the stretches they were doing.
It is possible that stretching into the pain provides temporary relief, typically lasting around 15-20 minutes. However, in most cases, the pain returns shortly afterwards. One patient aptly described this experience using the analogy of waves crashing on the shore: the pain subsides somewhat after stretching, only to come crashing back soon after.
2. A flexible spine is good for spinal health.
Many people believe that a flexible spine equals a healthy spine, or that a healthy spine is a flexible one. As a result, many individuals regularly engage in back stretches and various stretching exercise programs like yoga.
However, this isn’t true. Spine flexibility and pain are poorly correlated. People with flexible spines don’t have less back pain than people who don’t have flexible spines.
It is more important to have a stable spine than a flexible one. When we talk about a stable spine, we don’t mean a stiff spine, but rather a spine that has sufficient stiffness and control so that it won’t buckle under load. A stable spine allows you to safely move, lift, twist, and carry weight without risk of injury.
3. Rounding your back is bad for your spine– you should never round your spine
Some people say that rounding your back is not safe and that you should always try to keep your spine straight. Rounding your back, they often claim, leads to intervertebral disc injury.
It’s important to understand that the spine is designed to bend, so rounding your back (spinal flexion) isn’t necessarily dangerous in all situations. In fact, for most people and in most situations, spinal flexion is generally fine.
The spine is naturally capable of a wide range of movements, including bending forward (flexion), extending backward (extension), and rotating, which are all necessary for daily activities and exercise.
However, with that being said, there are times when minimizing or avoiding spinal flexion is advisable. Those situations would include the following:
- When rounding your back triggers your back pain, it is generally advisable to avoid it temporarily. Just as you would avoid twisting your ankle as it heals, it is wise to refrain from repeatedly rounding your back if it causes your back pain.
- Prolonged end-range flexion can increase the risk of injury. Just as it’s not advisable to pull your finger back as far as it goes and keep it there for a long time, similarly, keeping your back fully rounded for an extended period can also increase the risk of injury. For example, spending hours bent over in your garden with your back fully rounded can strain the structures of your spine and lead to discomfort or injury.
- Lifting with a fully rounded back or lifting with spinal motion (i.e., rounding and then straightening your back), especially when the objects are heavy or the lifting is repetitive, can increase the risk of injury.
4. Chiropractic adjustments help to reduce back pain by 1) putting bones back in place or 2) improving spinal alignment.
Many chiropractic patients believe that chiropractic adjustments put bones back in place or realign the spine. For many years, this was often how chiropractors explained what an adjustment did as well.
The problem with this idea is twofold:
- Most causes of back pain are not caused by bones being out of place or improper spinal alignment.
- There is no evidence that shows chiropractic adjustments put bones back in place or change spinal alignment.
It is more accurate to understand chiropractic adjustments as modulating pain by influencing the neurology of the spine. Essentially, adjustments can “turn down” the volume of pain and improve communication pathways between the body and brain.
5. MRIs reveal the cause of back pain.
MRIs are a phenomenal invention. They can show the structure of the spine, including damage or structural changes, in very minute detail.
This is both good and bad. The good part is that MRIs can be very helpful in diagnosing the cause of someone’s pain.
The bad part is that MRIs show both fresh wounds and old scars. This means that an MRI by itself can’t reveal the cause of pain. Just by looking at an MRI, it is often impossible to know which structural changes are relevant to a person’s symptoms.
Therefore, it is necessary to correlate what is seen on an MRI with the results of a physical examination.
For example, it is possible for a disc bulge seen on one person’s MRI to be asymptomatic, while the same finding on another person’s MRI could be the cause of their pain. Therefore, relying solely on an MRI to determine the cause of someone’s pain is not advisable.
Importance of accurate information and seeking professional advice for back pain management
It is very important, especially if you have chronic back pain, to receive accurate information regarding your condition. Accurate information can lead to a quicker recovery.
Inaccurate information can lead to at least 3 negative outcomes:
- An increase in pain as a result of doing improper stretches.
- Improper or unnecessary treatment, which can be associated with significant risks. E.g. unnecessary surgery
- Unnecessary fear regarding various everyday activities. E.g. Fear that if you allow your back to round, you are placing yourself at great risk.
Seeking advice from an expert in back pain management, such as a McGill Method provider, can help you overcome your back pain. This is especially important if you have already tried various other therapies or treatments without success.