Back pain myths busted: What you really need to know

Back pain is a common health problem. However, despite its prevalence, many misconceptions about its causes, treatments, and prevention persist, leading to prolonged discomfort.

This article provides an expert insight into back pain, explaining the facts, and what you really need to know.

What are common myths vs facts about back pain?

Myth 1: Back pain is always caused by a problem in the spine

Truth: In addition to the spine, back pain can also be referred from other areas, like the hips, kidneys, or abdomen. Sometimes, pain originates from muscular issues, not necessarily spinal problems.

Myth 2: Back pain is always caused by injury

Truth: While back pain can result from injuries like muscle strains or accidents, many cases occur without a specific incident. Stress, poor posture, weak muscles, underlying medical conditions (such as arthritis or herniated discs), and even lifestyle factors (such as prolonged sitting or physical inactivity) can cause back pain.

Myth 3: Rest is the best cure for back pain

Truth: Prolonged bed rest can actually worsen back pain. Staying active with gentle movement helps speed up recovery by keeping muscles flexible and strong and reducing stiffness. Light activities like walking are encouraged.

Myth 4: Surgery is the only treatment option for chronic back pain

Truth: Surgery is rarely the first line of treatment for chronic back pain. Most cases can be managed with non-surgical interventions like physiotherapy, exercise, or medications. Surgery is needed in only a small number of cases.

Myth 5: Back pain is a lifelong condition once it starts

Truth: Most back pain is temporary and can resolve with proper treatment and self-care. Chronic back pain is less common and can often be managed effectively with lifestyle changes and professional guidance.

How is back pain investigated?

Your spinal surgeon will first ask about your symptoms, when they began, which activities worsen or improve the pain, and any past injuries or medical conditions.

Next, a physical examination will help your surgeon assess your range of motion, reflexes, and muscle strength. They may also check for signs of nerve compression, such as numbness or tingling in the legs.

In some cases, imaging tests will be needed to get a clearer picture of what is going on in the spine. Common imaging tests include:

• X-rays: X-rays can show bone abnormalities, fractures, or signs of arthritis.
• MRI: An MRI is the gold standard for diagnosing soft tissue injuries, such as herniated discs or nerve compression.
• CT scans: A CT scan may be recommended if more detail is needed after an X-ray.

If your surgeon also suspects nerve involvement (for example, in cases of sciatica or a herniated disc), they may recommend nerve conduction studies or an electromyogram. These tests measure how well the nerves are working and can help identify areas of nerve damage or irritation.

When is surgery recommended for back pain?

Surgery is generally a last resort for treating back pain and is only considered after non-invasive treatments like physiotherapy and medications have failed to provide relief.

Most people with back pain will improve without the need for surgery. However, surgery may be recommended in specific cases, for example:

• If a herniated disc or spinal stenosis is causing significant nerve compression.
• If scoliosis or spondylolisthesis are causing structural issues in the spine, such as severe pain or dysfunction.
• If there is instability in the spine, for example, from trauma or degeneration.

Common types of back surgery include: discectomy (removal of a herniated disc), laminectomy (removal of part of the vertebra), and spinal fusion (fusion of two or more vertebrae together). Your surgeon will carefully evaluate your condition and discuss the potential risks and benefits of surgery before recommending it.