Time to Align: Myths and facts about back pain

Back pain affects between 70 and 80 percent of the adult population at some point in their lifetime.

Dr. Jamal Khan

When it comes to back pain, it is difficult to compare one person’s experience to another’s as there are so many possible causes. Often it is even more difficult to determine what is the best way to go forward with treatment.

Typically, people present to a healthcare professional for help after trying various home remedies, some of which work and some which may make things worse. The many myths about the causes of back pain and the best way to treat back pain only further complicates matters.

Myth: Back pain is what happens to other people.

Fact: Statistically, back pain affects anywhere from 70 percent to 80 percent of the adult population at some point in their lifetime. Issues related to back pain are the leading cause of disability of men over the age of 45.

Back pain is the second most common reason for a visit to a primary care doctor. If you have a spine, it is not if you will experience back pain but when.

Myth: Paralysis can occur with a bad low back injury.

Fact: The spinal cord ends in the upper part of the low back at the top of the lumbar spine just below the ribcage. Past that point, the spinal cord turns into what is called the Cauda Equina because it looks like a horse’s tail. These filaments are very tough and difficult to compress. Paralysis is only seen with severe issues such as spinal infections/tumors and severe spine fractures.

Myth: Severe back pain means something is really wrong.

Fact: The perception of pain can be magnified for several reasons. Depression, acute inflammation, emotional responses and muscle spasm can all magnify the level of pain that is experienced due to what would otherwise be considered minor issues.

Myth: An MRI scan or other diagnostic test is needed to diagnose my back problem.

Fact: Almost all back problems can be successfully treated based on the information from a thorough history and physical examination. An MRI scan should be performed if you are experiencing fever, muscle weakness in the legs, a change in bowel/bladder function, have a history of cancer, recent severe trauma or failure to respond to appropriate treatment.

Myth: Every problem found on the MRI should be treated.

Fact: Many people who have never had an episode of low back pain will have issues pop up on their MRI scan. Herniated discs and degenerative discs will typically show up on adults with no history of low back pain. An MRI scan may lead to unnecessary surgery and is thought to be the reason why there has been a 300 percent increase in surgery rates over the past decade. Typically, only 4 percent to 6 percent of low back problems require surgery.

Myth: There is a standard “cure” for most causes of back and neck pain.

Fact: It is likely the more spine specialists you see for low back pain, the more opposing diagnosis and treatment recommendations you will receive. Practitioners in different fields (chiropractors, physical therapists, orthopedics, family medicine) will often disagree on the diagnosis and the proper way to treat the condition. It is not uncommon for practitioners in the same field to widely differ in their opinions.

Myth: Low back pain means bed rest.

Fact: A short period of bed rest may help acute low back pain, particularly if there is disc involvement. However, more than two days of rest can actually prolong your recovery, increase pain and lead to other health issues.

Myth: Chiropractors crack your bones.

Fact: A chiropractic adjustment is a manual procedure that decrease pain and restores function of joints by improving joint mobility and the tone of the surrounding soft tissues. The audible sound sometimes heard during an adjustment is caused by the slight opening of the joint space and the release of gas within that space. It is the same sound heard when someone “cracks” their knuckles.

Myth: Obesity does not cause back pain.

Fact: The American Obesity Association reports episodes of back pain are prevalent among the nearly one-third of Americans who are obese. It is not known exactly how excess weight causes back pain. The leading theory is that the extra body weight compresses the joints of the spine and squeezes the intervertebral discs. Also, high amounts of belly fat can contribute to a “sway-back” posture which places greater stress on the joints of the low back.

Dr. Jemal Khan is a chiropractor based in the Cayman Islands.