80% of us will probably experience an episode of back pain at one point or another in our life (some studies say that it is even more) (1-3). So, if you think about it, back pain is very common. In fact, to not experience back pain at some point in our life would be quite abnormal. And it doesn´t matter if you have strong or weak abdominals, or if you have too much flexibility or too little, or if one leg is larger than the other, or if you walk in a funny way, none of these factors will influence you experiencing an episode of back pain (4-8). To tell you the truth, the biggest factor for developing back pain is a history of back pain!!! (9). Sounds crazy but it is true.
So, instead of focusing on prevention of back pain (which we have already done for the last 20 years and nothing has changed), maybe we should focus on ¨how do I prevent my back pain from lasting so long¨. You see, when they experience back pain people get really scared, and get fearful of movement, which are two things that can actually make the back pain worse (10-11). Remember, we know the body needs movement to heal. Disk and cartilage etc. need movement to get their blood supply. So in most cases we should try and keep movement. Only when the pain is really bad should we rest but that rest should never be longer than 2 days (12). Pain does not equal tissue damage and it can be influenced by stress, beliefs, fears, anxiety and a thousand other things (as I have stated in previous blogs click here). Our body, including our back, is a wonderful strong machine. We have to start changing our beliefs around the idea that our back can get damaged easily or that our back is vulnerable.
In conclusion, we will all probably experience an episode of back pain in the coming weeks, months, years or whenever, just like we will probably experience a headache or a stomach pain. It is part of life and we shouldn´t get too worried. Studies say that 85-90% percent of the time we have back pain it is due to ¨non specific mechanical factors¨. This basically means we have no IDEA why your back hurts but it does. Only 2% of the time the pain is caused by a tumor, infection or a fracture and 8% due to a nerve compression (13-15). So next time your back hurts don´t be so afraid and keep moving. 😉
- Biering-Soeren2012 Feb 4;379(9814):482-91. doi: 10.1016/S0140-6736(11)60610-7. Epub 2011 Oct 6.se F. A prospective study of low back pain in a general population. Occurence, recurrence, and etiology. Scand S Rehabilitation Med 1983;19:71.
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- Taylor JB, Goode AP, George SZ, & Cook CE. Incidence and risk factores for first-time incident low back pain: a systematic review and meta-analysis. Spine Journal 2014
- Gheldof EL, Crombez G, Van den Brussche E, et al. Pain related fear predicts disability, but not pain severity: a pathway analytic approach of the fear avoidance model. Eur J Pain.2010;14:870
- Awinkkels-Meewisse IE, Roelofs J, Schouten EG, Verbeek AL, Oostendorp RQ, Vlaeyen JW. Fear of movemen/ re injury predicting chronic disabling low back pain: a prospective inception cohort study. Spine( Phila Pa 1976) 2006;31:658-664.
- Deyo RA, Diehl Ak, Rosenthal M. How many days of bed rest for acute low back pain? New England Journal of Medicine 1986;315:1064.
- Agency for HEalth Care Policy and Research (AHCPR). Acute low back problems in adults. Clinical Practice Guideline Number 19. Washington DC, US. Government Printing. 1994.
- Danish Health Technology Assessment (DIMTA). Manniche C, et al. Low back pain. Frequency Managemente and Prevention from an HAD. Perspective. 1991.
- Royal College of General Practioners (ACGP). Clinical Guideline for the management of Acute Low Back Pain. London Royal College of General Practicioner.1999