The Misconceptions of Lower Back Pain

Lower Back Pain (LBP) is one of the most common forms of chronic pain with an estimated 619 million people worldwide suffering from it making it the leading cause of disability globally. Recent research and clinical trials are shining a new light on this ‘achilles heel’ of the people, revealing that it has been profoundly misunderstood. 

Pain Reprocessing Therapy fundamentally differs from other treatments for lower back pain, in that it identifies the nervous system as the root cause and focuses on treating this rather than the symptoms themselves. The unprecedented success rates of PRT treatment of LBP are causing many doctors, and practitioners of all spectrums of physical therapy to question some common assumptions about Lower Back Pain. 

Several common misconceptions contributing to the misunderstanding of LBP are:

Misconception: LBP is Caused by Bulging or Herniated Disks. 

Bulging or herniated disks are often diagnosed as the cause of LBP, but evidence does not support a direct cause-and-effect relationship. These conditions are common and frequently symptomless. A systematic review by Brinjikji and colleagues in 2014 found that a surprising number of people without symptoms had disk problems. For example, 30% of 20-year-olds and over 60% of 50-year-olds had disc bulges without experiencing pain.

Similarly, herniated disks are not always linked to LBP. A 2006 study comparing MRI results with clinical observations found that in more than two-thirds of patients, the level of signs and symptoms did not correlate with MRI findings. Many asymptomatic herniated discs were observed with root compression. Considering that most people experience LBP in their lifetime, and many cases of bulging or herniated disks are asymptomatic, it is clear that these diagnoses do not adequately explain LBP.

Misconception: LBP is Due to a Lack of Core Strength or Poor Posture

LBP can affect people of all fitness levels and flexibility. Despite claims to the contrary, there is no solid evidence that posture or core strength causes lower back pain. Studies of LBP have found that they are nonspecific, meaning it is not possible to identify a single origin for the symptoms. 

The idea that being more fit or flexible will stop the pain is a comfortable fiction, it fits into our all-too-common narratives of being inadequate. If Lower Back Pain was due to a lack of fitness then it would never occur in athletes, in reality an estimated 10-15% of athletes are expected to experience LBP in a given year.   

Misconception: LBP is an Injury Caused by Bending Over

A common scenario involves bending over to pick something up or tie a shoelace, resulting in sudden back pain. While it may seem like the movement caused an injury, this is not the case. The average person bends forward thousands of times daily, and our bodies adapt to these regular movements. Sustaining an injury from such actions is virtually impossible. Understanding the role of the nervous system and the body’s protective mechanisms is essential to understand what is really happening in this scenario  

Another misconception is that lifting weight without a perfectly straight spine can cause LBP. The myth that it is dangerous to lift without a straight spine originated from a misunderstood study conducted in the 1960s. More recent studies have debunked this.

Read more about how Pain Reprocessing Therapy can help Lower back pain here, or book a call with me to discuss your symptoms.