Making sense of lower back pain

Apr 22, 2019

In most people back pain is benign and represents a simple sprain associated with bending or twisting movements or a flair up associated with lifestyle stresses. Only 1 to 2% of people presenting with back will have a serious disorder, such as cancer, infections  or spinal fracture. 

There is a common belief in society that backs are easy to damage and hard to heal. This often leads to a view that when a person develops back pain, a scan (x-ray, CT scan or MRI) is required to identify the cause of pain. However the latest research suggests that this is rarely true.

One of the problems with having your back scanned is they often identify things that sound scary but are actually normal and common in people without back pain. 

For example, “disc degeneration” and “disc bulges” are very common in people without back pain, especially  ageing people. 

These changes don’t predict the severity of a person’s back pain or level of activity limitation. However, being told you have “disc degeneration” or a “disc bulge” can lead people to believe their spine is damaged and needs protecting, resulting in a cascade of fear, muscle guarding and movement avoidance.

Triggers for an episode of back pain are things like inactivity or unaccustomed activity combined with being tired, stressed, sad and/or run down. 

This can result in muscle tension and sensitivity of the spine’s structures. Understanding that having back pain (unless you have had a trauma) usually doesn’t mean the spine is damaged, and that it’s safe to move, keep active, work and engage with valued activities is important to help with recovery.

The most effective things to manage back pain are the things you can do for yourself – good sleep, regular movement and physical activity, manage your stress and keep a positive mindset.

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