Demystifying back pain and how to beat it

Dealing with back pain is a debilitating and frustrating existence; our daily lives can be dominated by either the fear of pain or coping with flare-ups. 
The complex nature of backs and the unpredictability of treatment and management of back pain has led to a multitude of myths floating around, some of which were based from what the medical profession understood at the time. 
Thankfully, over the last decade, the understanding of backs and their relationship with injury and pain has improved immeasurably – yet unfortunately many of these myths persist. 
Demystifying back pain and how to beat it
31/3/20192 Comments
 
Dealing with back pain is a debilitating and frustrating existence; our daily lives can be dominated by either the fear of pain or coping with flare-ups. 
The complex nature of backs and the unpredictability of treatment and management of back pain has led to a multitude of myths floating around, some of which were based from what the medical profession understood at the time. 
Thankfully, over the last decade, the understanding of backs and their relationship with injury and pain has improved immeasurably – yet unfortunately many of these myths persist. 
​
Unpicking the myths of back pain
MYTH #1 – Moving will make my back pain worse
What used to be the perceived wisdom of bed rest has now been widely proven to actually hinder the recovery process and extend recovery times. Returning to movement as soon as possible has been shown to not only speed up recovery but also hugely reduce the recurrence of the pain. (1)

MYTH #2 - I need to avoid exercise, especially weight training 
We now know that exercise is the best form of treatment for both acute and chronic lower back pain. Interestingly, every study shows that there is no type of exercise that is better or worse for treatment giving you the freedom to do whatever form of exercise you enjoy and can tolerate. (2)

MYTH #3 - I need a scan to pinpoint and diagnose my problem
What used to be considered an essential diagnostic tool CT & MRI scans have now been proven to be fairly ineffectual in providing accurate diagnosis of lower back pain. While in certain specific cases scans can provide useful, in many the results are irrelevant to the cause and nature of the pain. (3)

MYTH #4 - Pain is a warning of damage 
How every individual experiences pain is as unique as a fingerprint and is rarely in proportion to the injury sustained. We each process and ​experience pain in a completely unique way that is affected by numerous factors, none of which are linked to the severity of the injury. (4)

The hidden causes of back pain
While the causes and contributing factors for back pain are vast and far too broad to make discussion relevant, what is of use is the research and studies into the factors that determine and influence the high rates of recurrence of back pain in sufferers. Crucially, this comes down to paths of treatment. 
A study by the Oregon Health and Science University published in the British Medical Journal (5) into prescribed opiate use for users suffering lower back pain. 
While the study acknowledged the analgesic effect on acute back pain, the study found no evidence of any benefit for those suffering from chronic back pain. In fact, the evidence points to pain medication giving little relief to patients and compared to alternative treatment, may actually exasperate the problem. 
Without placing the emphasis on patient led recovery through exercise and strength building, pain killers can often deceive the patient into not properly managing their pain and recovery, prolonging their symptoms and hugely increasing recurrence of the pain – the wrong treatment path can actually be the cause of your pain.

The 3 simple steps to regaining your independence and taking control of your back pain
It’s very easy to allow back pain to take over and dictate how you live your life. The debilitating pain makes clear planning and a positive outlook a hard place to get to. However, these three steps are the key to turning your life around and empowering you to live your life on your terms.

1. Motion is lotion!
Know that movement and exercise is the key to recovery and reducing flare-ups and recurrence of your pain. There’s a reason that physios and doctors keep repeating the phrase motion is lotion!

2. Stop masking the issue
Understand that purely treating your symptoms is a shortsighted approach that will cost you money and not solve your pain or give you any long-term solutions. We now know that effective treatment involves exercise and building up strength, pain medication may or may not offer you temporary relief in what becomes a constant cycle of pain and flare-up.

3. Plan your attack
Get an effective plan of rehabilitation and growth from a physiotherapist to safely end your cycle of injury and build yourself an effective strengthening plan that works best for you. All the medical evidence shows that exercise and strengthening has the best short and long-term results for patients with both acute and chronic back pain.

Looking to the future: What will my back cope with without recurring injury
Here’s the thing, the more back strengthening you do, the more your back will cope with. The traditional thinking of treating back pain of rest and medication actually served to make patients far more susceptible to further injury.
A carefully executed plan of exercise and strengthening will see you able to take part in the most rigorous of activities, even a high impact sport such as rugby. In fact, a study conducted by South Africa Rugby (6) on the impact of lower back pain on elite players found that of all treatment, exercise was by far the most effective and recommended that in order to combat recurrences of injuries, players should follow a physio led training programme of core stability and strength training.

Notes and References:
1. http://www.nhs.uk/Conditions/Back-pain/Pages/Treatment.aspx
2. https://www.spineuniverse.com/wellness/exercise/weight-lifting-back-pain
3. http://www.spinesurgeons.ac.uk/patients/patient-information/the-spine-and-mri-scanning
4. http://bjsm.bmj.com/content/early/2017/07/12/bjsports-2016-097383
5. http://www.bmj.com/content/350/bmj.g6380
6. http://www.sarugby.co.za/boksmart/pdf/
BokSmart%20Lower%20back%20and%20core%20paper.pdf
7. https://www.epsom-sthelier.nhs.uk/centre-of-pain-education
8. http://www.sciencedirect.com/science/article/pii/S1466853X16000328