We hope that you’re well!
We see a wide range of injuries every week. One of the most common, and one that we have seen an increase in the last couple of weeks, is lower back pain (LBP). It has been reported that around 35% of us suffer with LBP (Fayaz et al.,2016). LBP can be a symptom of many injuries and conditions which are often easily treated and rehabilitated.
Over the next few weeks we will be completing some blog posts around the types and causes of LBP, how to strengthen the lower back, manual therapy techniques and prevention tips. With LBP being so prevalent amongst our patients, it also brings along with it many misconceptions in relation to back pain and severity and rehabilitation.
Some of the lower back pain misconceptions we see in the clinic.
Thinking rest is best
Although an element of rest is needed for recovery and healing, moving and exercising has proved to be successful in terms of recovery and rehabilitation of lower back in comparison to bed rest (Balague et al.,2012). A lack of exercise during injury can lead to muscle atrophy (wastage) in the injured or surrounding tissues, which can delay the rehabilitation process or cause further injury. The position in which we sleep can contribute to LBP alter the flexibility of the spine and the surrounding muscles. This is usually what happens when people say they have a “Creak” in their neck after sleeping which can be caused by poor quality or older pillows which need replacing. By sitting in the same position for long periods, the flexibility of the muscles in use can be altered, this can be seen in office workers, as some muscles become shortened and inflexible and others elongated and weak. These issues can be rectified by a progressive strengthening and soft tissue treatment plan.
“I think a scan is needed”
The vast majority of patients with LBP do not require a scan. Even those of us who do not suffer with LBP may show abnormalities or changes on scans. Scans aren’t always helpful or needed in terms of injury diagnoses (Webster et al.,2010). The picture below is an example of a degenerate disc, which is black in colour, in an individual who has had no traumatic injury.
The majority of lower back pain causes can be identified through physical assessment. Once an assessment has been completed the majority of LBP issues are rehabilitated through a controlled rehabilitation programme. It is important to initiate a strengthening programme consisting of controlled loading progressions. It is important that these are gradual, as sudden increases in acute load can worsen LBP symptoms. Soft tissue work such as massage can aid the recovery alongside a flexibility/mobility plan. It is important to consider modifying one’s activity such as sleeping and sitting arrangements, by altering posture and introducing exercises.
A weightlifting belt will help me
Weightlifting belts have been a staple with many weightlifters and gym goers over the years. One of the main misconceptions about weightlifting belts is that they support the spine, however due to their narrowness and rigidness it is a myth! (Renfro and Ebben et al.,2006).The abdominal muscles (not just the big “6-pack” muscle, but the intrinsic core muscles) are vital in the building of back strength and the prevention of injury, but research has shown that weightlifting belts discourage these muscles to act and essentially “switch off” (Baechle et al., 2008). When these muscles “switch off”, a muscle imbalance is caused, due to this, the lower back cannot stabilize during movements such as bending forward, because of this there is a high risk of injury.The relationship between the lower back and the abdominals consists of a complex relation between muscles, sensory influences and biomechanical forces. These relationships, along with proper technique, should be considered when rehabilitating a lower back injury or preventing a lower back injury which weightlifting belts do not address.
Pain levels relate to severity of injury
Many patients believe the severity of their pain is equal to the damage. This is not the case, everybody reacts differently to injuries. Everyone’s brain perceives injuries and pain differently causing symptoms to be more exaggerated in some (Manchikanti et al.,2014). Through our assessments we can determine the extent of the injury and structure a bespoke rehabilitation plan. Any level of pain that is ongoing should be explored regardless of the intensity.
Now that there are a few misconceptions addressed, over the coming weeks we will be providing you with key information in relation to LBP causes, treatments, strengthening, pain management and prevention.If you have an queries at any point about LBP, no matter how small, please feel free to Contact us via Facebook, email or telephone.