Fear of back pain is often very significant, however many of the commonly held beliefs in society about back pain are misleading and at times harmful.
The Lancet has recently published a wonderful review article (March 2018, What low back pain is and why we need to pay attention. Hartvigsen J, et al.) and we wanted to share some of the key points!
The abstract for this article is included at the bottom of this page.
So dot point summary style… here is some key info which is very worth understanding:
Back pain is a symptom, not a disease.
You don't treat a runny nose, you overcome the cold... the 'pain' bit of back pain is the symptom!
For most people it is not possible to identify a specific structure that is directly causing their back pain.
Even with imaging! The relationship between something being reported on a scan and a person's experiences of pain (or no pain) is very weak.
Back pain is complex! The correct answer to 'why do you have back pain?’ or ‘what is causing your back pain?’ is not likely to be a simple, one stage answer.
As much as we would often like to have something specific to blame... this is actually a good thing! See the next point...
Many factors impact low back pain and the degree of impact it has on you.
These may include lifestyle factors (general health, diet, smoking, other stressors), health factors (other chronic conditions or mental health), genetic factors, financial stress, physical ability and physical daily requirements, movement skills and more.
This is a good thing! Multiple contributing factors means multiple paths to improvement!
Most episodes of low back pain are short lasting, though recurrent episodes are common.
Short doesn't mean pleasant! Suffering back pain also doesn't automatically mean a 'bad back' for life!
Recurrent back pain should be considered as one complex condition rather than unrelated events.
It's your back, it's impacted by your life, it's important to learn from each episode of pain rather than approaching each event as a brand new thing!
Please note that the scope of this article did not include an analysis of treatment options or approaches.
So as much as it would be awesome if back pain was simple, it's not. This isn't all bad though, if the cause of your back pain is multifaceted, that means that there are a number of things to target to help you feel better!
If/when you experience back pain, rather than focusing on what has gone wrong, it might pay to focus on what you need to do to feel good again!
So Step 1 - As the first of our TMT principles states… Understanding is Key!
Step 2 - Once your individual circumstance is best understood by yourself and your Physio, an individualised approach and goals can be put in place (and achieved!).
As always, if you have any questions please contact us via facebook, email (firstname.lastname@example.org), phone, instagram or in person!
Many thanks for reading,
The Movement Team
Importantly and as always, all information included here is general in nature and for your own individual health, please see your local health professional.
What low back pain is and why we need to pay attention.
Hartvigsen J, et al. Lancet. 2018.
Low back pain is a very common symptom. It occurs in high-income, middle-income, and low-income countries and all age groups from children to the elderly population. Globally, years lived with disability caused by low back pain increased by 54% between 1990 and 2015, mainly because of population increase and ageing, with the biggest increase seen in low-income and middle-income countries. Low back pain is now the leading cause of disability worldwide. For nearly all people with low back pain, it is not possible to identify a specific nociceptive cause. Only a small proportion of people have a well understood pathological cause-eg, a vertebral fracture, malignancy, or infection. People with physically demanding jobs, physical and mental comorbidities, smokers, and obese individuals are at greatest risk of reporting low back pain. Disabling low back pain is over-represented among people with low socioeconomic status. Most people with new episodes of low back pain recover quickly; however, recurrence is common and in a small proportion of people, low back pain becomes persistent and disabling. Initial high pain intensity, psychological distress, and accompanying pain at multiple body sites increases the risk of persistent disabling low back pain. Increasing evidence shows that central pain-modulating mechanisms and pain cognitions have important roles in the development of persistent disabling low back pain. Cost, health-care use, and disability from low back pain vary substantially between countries and are influenced by local culture and social systems, as well as by beliefs about cause and effect. Disability and costs attributed to low back pain are projected to increase in coming decades, in particular in low-income and middle-income countries, where health and other systems are often fragile and not equipped to cope with this growing burden. Intensified research efforts and global initiatives are clearly needed to address the burden of low back pain as a public health problem.
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