In Part 1, we talked about some of the concepts of back pain with respect to the regional interdependence concept and how local pain does not tell us about the the cause but in fact might only be the symptom of other underlying dysfunctions. In part 2 of our 3 part series, we talk about the common myths and misconceptions around back pain. Have a read and see if you have heard these sayings before!
It is absolutely possible for us to put “out” our back, but very few of us will. If you have absolutely put “out” your back, what you would need is not a therapist but a surgeon to surgically correct (or “put in”) your spine. This kind of injury is rarer and much more traumatic, usually something like a car crash. For the majority of the population, we do not "put out" our backs. Rather, what we experience is a form of back sprain or strain which results in a stiff and painful spinal joint or two and associated muscle spasm. The stiffness and pain could be in a particular direction, hence the feeling of it being "out" in a particular way. Your therapist would then reduce the stiffness in that direction which would help to reduce the pain – we can’t put it back “in”.
There are genetic back problems that are passed down from your parents or ones that you are born with, that is true. These come in a variety of forms such as a fusion of two vertebrae (spine bones), various forms of inflammation of the joints (rheumathoid arthritis, ankylosing spondylitis), and inherited scoliosis. These are medical conditions that are present but uncommon. For those of us who hurt our backs lifting something or sitting for too long or bending over, such medical conditions are usually not the cause, and hence we did not inherit our “bad backs” from our parents, we developed it in our lifetime through environmental influences and postures.
There’s always a concern about "clicky" joints: backs, shoulders, knees etc. As far as science has shown us, clicking itself is neither good nor bad. It simply means that your joint moved. We know some of our joints click more than others. However, these clicks are not indicative of a “bad” joint, neither does it indicate a “good joint after its clicked”. What determines if its good or bad is more complex than that such as: Is it restricted? Is it painful to move? Is it loose? These are more indicative of a “bad” or “good” joint. If you have any concerns, feel free to visit your local therapist!
On the topic of painful clicky joints, pain itself is an important sign that should NOT be ignored. Pain is the way our body tells us something is wrong, something needs to change. However, what is wrong may not be as simple as where the painful site is. First of all, the intensity of pain (how painful it is) does NOT correlate with the extent of damage (how damaged a structure is). For example, a pulled/strained ligament may be more painful than a completely torn one – this is because a strained ligament is painful when stretched, while a completely torn ligament cannot be stretched, even though the damage is heavy.
Going back to the idea that pain is not equals to damage. Damage also does not mean cause. For example, if you have a strained calf when you’re running, the diagnosis is usually quite simple: you damaged the calf muscles that’s why it’s painful. However, the diagnosis is not the cause.
The cause can be much more complicated than that. If you’re running without your hips or feet or even trunk and arms to push you forward, then of course your body will be less efficient – but it still needs to run. The power had to come from somewhere else, it may have come from the calf, that’s why it got strained and damage. It was not the calf that was causing the problem, it was the other body parts that was not working well and causing the calf to compensate.
These are just some of the common phrases/sayings we hear in the clinic and which are thrown around quite often. We hope this has shed some light on the "myths" of back pain and that we have explained these concepts a little more in depth.
In part 3, we look at some mobility and management strategies that could help in general day to day. As always, this does not replace medical advice. If you do suffer from (lower back) pain, please do seek help from a trained medical professional.
Thanks for reading!