Back In Shape recently featured in The Daily Mirror, a national newspaper in the UK. This post is an expansion on the back pain myths covered for Daily Mirror readers. We thought it worthy of reiteration here as these back pain myths are common and play a significant role in the prevention of back pain relief. If you can start to more effectively understand these myths and rationally overcome them, you will find your back pain will begin to improve.
*You can read the full article published on the 20th September 2022 at the bottom of this page
Granted you have to continue to make strides with the correct rehab, the program can help you with that! Before we get into the back pain myths themselves, it’s worth identifying that oftentimes people will begin the correct exercise program but continue to partake in these “incorrect” actions. For real success you need to eliminate bad habits and practices at the same time as doing the correct exercises and practices.
Stretching solves back pain
Think about it, even inflammation in your stomach causes muscles spasm as you round yourself over in pain, you would hardly start massaging or stretching your abdominal muscles. So why is the inflammation around your spine that’s causing back or hamstring muscle spasm treated differently.
As a good rule of thumb, injury in joints of the body, which leads to inflammation, will lead to a degree of muscle spasm or tension. Muscle spasm or tightness is never a primary problem. Yet when it comes to lower back pain this simple fact seems to have been forgotten.
In response to that first sensation of back tightness or pain, most immediately gravitate to stretches of the back or leg muscles to “relieve tension” that has built up in the back under the false idea that the sensation of tension is itself the problem rather than a symptom.
Back injuries, especially the sort that build up slowly over time, will nearly always first manifest with a degree of stiffness in the back. This stiffness is often ignored for a considerable degree of time, until symptoms worsen. Then we engage in a myriad of stretches.
the primary issue with these stretches is that they do not address the underlying cause of back pain, whats worse, the way in which many of them are done, from the glute stretch and hamstring stretch, to the piriformis figure 4 stretch and knee hugs; they all have one thing in common. Flexion of the lumbar spine. This flexion makes things worse as it is replicating the very mechanisms that caused the problem in the first place, restraining the same tissues whilst simultaneously doing absolutely nothing to address the original, and persistent weaknesses that contributed to the back injury.
Using heat for back pain instead of ice
In recent years, especially for peripheral injuries, like sprained ankles, there has been a concerted shift towards heat to help with the healing process as opposed to ice for extended periods. As with all things how we use the ice is important and we’ll get to this in a moment.
The simple fact of the matter is that in the context of a peripheral joint heat makes sense. There are minimal concerns tied to greater than usual levels of inflammation in the region and the presence of this increased circulation is somewhat helpful in ensuring the that the area heals effectively as using Ice for extended periods (20 minutes plus) is shown to be counterproductive.
The back however is very different for one primary reason. Boney holes. Much of the anatomy that becomes injured in the lower back creates an inflammatory response deep within the spine. Be it a full blown disc herniation or a minor strain to the spinal ligaments. These holes have finite boundaries and do not stretch. Quite often people will have an MRI to be diagnosed with some form of disc injury but the disc is not “pressing on a nerve”. It is in these cases, the majority, that it is more likely the presence of excess inflammation in a confined space that is increasing the “pressure” in this region. This is why exercises like knee hugs provide short lived relief – it increases the size of these holes – but at a cost which we cover at great length in other areas of our website and on the Youtube channel.
Using heat here to drive the inflammatory process is not a good idea at all! It only serves to continue to drive the process and is not worthwhile in the grand scheme of things. Ice on the other hand, done for short periods of time, typically 3-5 minutes maximum has an effect of just controlling excessive inflammatory build up, whilst not “freezing the area” as would be done if used for extended periods of time.
Over the years in clinical practice and more recently with members this method, as well as the more involved contrast bathing approach, works noticeably better in those with everything from minor back pain to more server back injuries like bugling discs and spondylolisthesis.
Once you develop back pain you’ll have it for life
This one is entirely in your control. The simple fact of the matter is that most approach back pain as an inconvenience, which it certainly is. As soon as the pain subsides, rehab subsides too and the underlying issues, weaknesses and bad habits remain. This is often because the individual with the back injury is not full educated on the matter.
It is very common, more so in the athletic fields, to find that someone who’s injured their shoulder works so thoroughly on their injured shoulder that it is more robust and healthier after the injury than their “good one”. They’ve spent the better part of a season perhaps, working and refining, rebuilding this shoulder. That’s not to say they couldn’t have a freak accident again, but it does not mean they will have the problem for life.
With back pain however the tissues are slow to heal and the appetite for rehabilitation diminishes so rapidly, the very moment that inflammation has subsided enough to permit some form of normal activity, they’re right back at it.
Granted it is difficult in some ways, for example, many with back pain will find that their pain goes long before the tissues are healed and remodelled (restrengthened). We see this in the case of a broken wrist, the pain goes before the cast comes off, it is just that the wrist is more consciously used on a daily basis. Combined with the physical presence of a cast, this makes for a much more compliant patient that goes through a more effective rehabilitation process.
We see a similar story with antibiotics and antibiotic resistance, people feel better before “recovery” has taken place, and so stop following the protocol early.
Suffice to say, the validity of this particular myth is entirely in your hands.