Myths about Low Back Pain
Lower back pain (LBP) has become a global epidemic and is the most commonly seen musculoskeletal condition in rehabilitation settings.
My name is Clarence Lau, and I am the head physiotherapist at Lawrence Park Health Clinic in North Toronto. I would like to share a video from pain-ed.com that discusses the myths about low back pain that need to be dispelled! In this short clip, Professor Peter O’Sullivan, a renowned clinician and researcher of LBP from Australia, speaks about the ongoing issues with the assessment and management of low back pain.
This is an informative video that everyone should to watch:
Did you know?
- Only about 1% of back pain disorders are attributed to really serious issues, such as: a malignancy, fracture, or inflammatory disorder
- Only around 5% of back pain is linked to disc prolapse, where there is some type of nerve compression
- The majority of back pain disorders are categorized as being non-specific and have no diagnosis based on diagnostic scan (X-ray, ultrasound, MRI, CT scan)
So what’s the problem?
- The problem we have created is this: we now have highly sensitive imaging techniques like MRI scanners, that pick up “abnormalities” in almost everybody, because if you scan anybody’s spine:
- About 90% have degenerative discs
- Around 45% have disc bulges, protrusions, or annular tears
- 20-30% have facet joint arthrosis (degeneration or arthritis)
- So we have created the belief that back pain is caused by these findings on scans, which may NOT predictive of back pain! In fact, these findings may be NORMAL.
Take Home Points:
- Abnormalities on X-Rays, MRI, CT Scan may not be predictive of LBP
- The causes of LBP are multi-factorial – it is not solely about structure!
- Pain can also be caused by abnormal movement patterns (muscle tension, poor posture, muscle guarding) and stress related factors (high stress, poor sleep, depression, anxiety), which can all sensitize the body’s perception of pain
- The spine is a strong structure that is not easily injured/damaged
- It is OKAY to bend forward and bend backward
- Overprotecting the low back can lead to increased muscle guarding and subsequently more pain
- Pain does not equal structural injury. Movement is good for the body!
- Don’t be a couch potato – try to continue doing the activities that you love most!
Author: Clarence Lau, BSc (Hons), MPhtySt
Toronto Registered Physiotherapist | Acupuncture Provider