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Author Topic: May 07 Healthletter.- Back Pain Myths  (Read 7253 times)

Steve Lockhart

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May 07 Healthletter.- Back Pain Myths
« on: May 12, 2007, 10:02:41 PM »
There is so much misinformation about back pain going around confusing sufferers I thought I would dedicate this newsletter to giving you my thoughts on some of those myths, hopefully to clear up some questions for you rather than confuse you further.

Remember these are opinions I have based on my experiences and they may vary from what you have been told previously by your therapist or medical practitioner.

The first myth I want to cover is:

1. Most back pain will clear up with or without treatment within 12 weeks.

It is easy to dispel this myth because a study reported on in the British Medical Journal (BMJ) has done the hard work by proving this is in fact not true. They found that up to 12 months after a person gets back pain around 50% of cases are still causing a problem.

The reason as I see it, is because most back pain is not the result of a single incident or injury but more likely something that creeps up on you and appears and stays for no apparent reason. It is often triggered by an activity that you have done numerous times in the past without a problem. When pressure builds up on a joint over a long period of time it just takes that one movement or lift too many for a problem to be triggered. That last movement is just the straw that broke the camels back so to speak.

Because most back pain comes from muscle imbalance or dysfunctional structural muscles it is very unlikely it will go away on its own. These problems are usually well entrenched into the body over  a long period of time and therefore need a high level of expertise and effort to get rid of them. When a problem does go away on its own with rest it settles down rather than leaves the body and the potential for another acute episode is usually not too far away.

One of the main reasons people are being told this myth is because when a person doesn?t return to their doctor with their pain after the initial consultation, the doctor assumes they are better, not realising that they have just decided to seek an alternative solution.

2. Back pain is caused by a strain or sprain to a ligament or muscle in the back.

It amazes me how many authority web sites on the Internet list this as the cause of back pain. The fact is this is the back pain but the cause is something totally different. The fact that the cause is very rarely where you feel the pain makes it that much more difficult to successfully diagnose that cause.  If a doctor or therapist is only concentrating on the site of the pain in their examination, the chances of them solving the problem is very remote.

The injured or inflamed area is the result of pressure that builds up from what is going on with the rest of the body. If we are standing on level ground, carrying the weight of gravity around whenever we sit or stand it is only logical that the balance in the rest of our body will have a large bearing on how pressure is distributed when we exert ourselves, whether that is running, walking or even sitting or standing for long periods. If the pelvis tilts or rotates then that pressure often ends up on a ligament or muscle in the lower back, causing tightness which our movement irritates, thus the inflammation, strain or sprain.

If you are told or read that your pain is caused by the strain or sprain or even the inflammation for that matter, you will know it is time to move on and keep looking for a solution elsewhere. This goes for a diagnosis that identifies a part of your body as the cause like the SI Joint or the L4/L5 disc problem that triggers sciatica.

3. Staying in bed for more than one or two days can make your back pain worse.

Making a judgement like this one is wrong for one very good reason and that is all bodies are different. If your body is normally strong  and your pain has come because you have overdone things in some why and set off an attack of sciatica or muscle spasm, then up to 4 or 5 days of bed rest can be just what you need to get mobile again.
If on the other hand your body is weak and your problem came because you over did things then even two days in bed is probably too much and you really should be doing some self help techniques to work on the tight or dysfunctional muscles. After that, working on putting strength back into your body so it doesn?t come back.

The thing to remember here is there is no one solution for everyone?s back pain and there is no one piece of advice that applies to everyone either. So if you read or are told a ?rule? that applies to all back pain sufferers just discount it because although it may apply to some it is unlikely to apply to everyone.

4. Chiropractic is the most effective treatment for back pain.

I don?t know how many times I have read a brochure or web site for chiropractic services stating this which was supposedly the conclusion of some research that was done.

A recent article on ?Joint Mobilization for Injuries is it Worth the Risk?, written by Steve Robson co-editor of the Physiotherapies Pain Association?s journal concludes that, ?In view of the available scientific evidence regarding the risks and benefits of manipulation it appears that there are no cirposted by a loserstances in which it would appear appropriate to recommend the use of manipulation in clinical practice.?

His article quotes at least 20 references and goes on to point out that possible injuries resulting from spinal and pelvic joint manipulation includes;
Vertebral artery/ internal carotid artery damage resulting in death, stroke or embolisms, or
Intervertebral disc injuries causing compression of the spinal chord, which has resulted in , paraplegia, permanent paralysis to nerves controlling the bladder and bowel leading to incontinence.
Nerve root compression eg. Sciatica and brachialga
Fractures of the vertebrae, especially older women with osteoporosis.

All scary stuff in my mind when you are seeing someone to get rid of your back pain or sciatica.

It has always seemed to me that the risks far outweigh the benefits and personally I have seen many people who have spent hundreds of dollars on chiropractic sessions with no result and even some who have received serious injuries they didn?t have before from being manipulated.
Although there are some people who think a manipulation is great but from my experience any benefit that is obtained from a joint manipulation can be got just as easily and more safely from other bodywork methods.
If you have any other ?Myths? or back pain ?rules? you would like to bring up why not make a post about them.
« Last Edit: May 04, 2009, 05:10:18 AM by Steve Lockhart »


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