Lower back pain is the leading cause of disability worldwide. In Australia, it is the second most common reason for visits to GP clinics and ranks among the top five presentations in emergency departments. It is thought that one in six Australians suffer from lower back pain, and it is estimated that up to 80% of the population will experience back pain in their lifetime. Additionally, back problems are the leading cause of lost work productivity and income poverty, with low back pain being the most common health reason for early retirement.
There are many unhelpful and potentially harmful myths surrounding lower back pain. Lower back pain can develop over time or following a specific event such as picking up a heavy object. This can create high levels of fear and stress surrounding potential tissue damage, often thought to be a ‘disc bulge’ or ‘arthritis’. This often leads to the expectation that a scan is needed to identify the structural damage and that surgery or injections may be necessary to return to normal function. In reality, structural ‘abnormalities’ are not so unusual and are a common finding in people without pain or disability to their lower back. In fact, fear of movement, negative expectations for recovery, and poor pain coping behaviours have a stronger association to persistent pain than does tissue damage.
Strong connotations between pain and structural damage can be harmful, as it leads to unhelpful beliefs that movement is dangerous. Bed rest is the most common self-prescribed treatment for lower back pain, as lying is often the most comfortable position. However, prolonged rest can lead to fear of movement and a feeling of fragility, resulting in more intense and persistent pain. When the back is sensitive, some movements may feel threatening. However, our spine is designed and supported to move in all directions. Therefore, graduated exposure to movement is both safe & healthy for the spine, but the appropriate level of exercise will differ based on each individuals capacity.
Poor posture and a weak core are common terminology associated with the onset and exacerbation of lower back pain. However, spinal postures during sitting, standing and lifting are not predictive of lower back pain. Tune in to the Paris Olympic weightlifting to see some of the strongest people in the world lift heavy weights with rounded spines. Furthermore, sitting upright in ‘good’ posture often leads to increased overactive back muscles creating feelings of tightness & pain. Whilst rounding may at first feel threatening, allowing your back to relax into support such as a pillow can be an effective way to reduce discomfort. For similar reasons it is also important to let your core relax when moving. Constantly bracing to perform tasks encourages conscious protection. It is important to utilise strength when it’s needed, but it’s equally important to match the level of effort to the difficulty of a task. For example, it’s not efficient to stand up from a chair with the same intensity you would use to pick up a couch.
Whilst lower back pain can be scary, there are many non-invasive and effective treatments available. Here at The Health Collab we look to empower our clients through education, to foster a positive mindset and optimise their physical as well as mental health. No matter how long you or someone you know has had back pain for, we are confident that our approach can make a positive change.
