Read on to find out common back pain myths debunked
Back Pain Myth 1. ‘It’s just part of getting older’
Actually, no. (Well, you are getting older..but getting older is probably not the reason your back hurts).
After the age of 40, it’s unusual to see medical imaging of spines without evidence of ageing (like thinning of discs and thinning of articular surfaces). These radiological findings are, however, largely irrelevant to pain (as the next myth below about MRIs will explain). Signs of spinal degeneration are present in amazingly high percentages of healthy people with no problem at all.
If back pain was mainly down to ageing and degeneration in the spine, surely younger people would have less back pain than older people? If low back pain were caused or even aggravated by ‘wear-and-tear’ on spines, you would not only expect to see more back pain in older people, but worse back pain in older people. But we don’t.
If spines were fragile, and if their fragility was driving low back pain, then the thirty-year-old back pain patient, on average, would be much better off than the sixty-year-old back pain patient. Yes people in their thirties and even twenties routinely get severe back pain in numbers so staggering that they are routinely cited for their economic significance. In fact, there is evidence that people actually get less back pain as they age.
Although certain types of back pain are relatively absent in the young and become increasingly common with age, it doesn’t affect the overall trend: most back pain occurs in the thirties and forties, either actually declining in the fifties and sixties, or at least not steadily increasing — exactly the opposite of what you’d expect if back pain was mainly caused by the degeneration that we know is occurring.
A great many younger patients with no history of injury suffer from extremely severe pain — pain that is well out of proportion to the degeneration that cannot possibly be significantly afflicting their spines at their age.
Although they aren’t immune, older people are actually relatively free of low back pain. It’s the thirty&fortysomethings that generate the horrifying low back pain statistics.
Back Pain Myth 2. ‘My MRI is ‘normal’ so why am I in pain?’
MRIs (and X-rays) have been shown to be pretty useless – worse than useless, in fact – in diagnosing or explaining most cases of lower back pain.
There is a very poor correlation between the presence of things like ‘disc degeneration’ or other scary sounding terms and the actual symptoms experienced by patients; far less the actual causes of those symptoms. It is very common to have a relatively ‘unremarkable’ MRI yet be in a great deal of pain and, conversely, to have an MRI showing all kinds of findings, and be pain free.
First, X-rays and MRIs genuinely spook people! It strongly reinforces the idea that something might is broken or crooked, a common and extremely misguided idea about back pain (and many, many other problems). And nothing is worse for back pain than fear. Fear is the “back killer.”
Doctors should avoid giving people X-rays and MRI unless the clinical situation is really rather bad, such as severe and persistent neurological symptoms.
Your spine isn’t misaligned