Throughout our lifetime, approximately 80% of us will experience some form of back or neck pain in our lives. This can range from the ever annoying "cricked neck", to the notoriously sensitive symptoms of Sciatica. However, we now know more about back and neck pain more than ever thanks to the world of medical research, and we hope to provide our top 8 knowledge bombs on the topic to help educate you further!
1) Back pain is no longer seen as a purely structural issue.
Long gone are the days where therapists used to claim to "pop discs back in" if they came out. For those that have spontaneous episodes of back pain, the likelihood is that there is another source for their pain and is more along the lines of the body increasing pain signals to increase soft tissue sensitivity, and therefore causing the onset of back pain.
2) MRI Scans/X-rays have a low correlation to symptoms
This one is VERY important. MRI findings of "degenerative change", "disc bulge" and "dehydrated discs" are all perfectly normal findings in the majority of people. Approximately 70% of all patients that are scanned will present with some form of structural change in their back/neck i.e. most people will have a disc bulge or arthritic change without ANY symptoms at all. The key thing to focus on is what is relevant to the symptoms you present with. So if the image doesn't match the symptoms, take it with a pinch of salt.
3) Back/Neck pain creates muscle stiffness which causes more harm than good.
Chronic pain can be quite complex, however, it promotes a "bracing" nature of the muscles surrounding the lower back/neck. Therefore, by bracing, everything is held very stiff and rigid in order to protect and prevent movement from occurring. Over a long time, this then becomes the norm for the body. To fix this, the body needs to re-learn to lengthen and shorten these muscles in a variety of different positions, and under differing loads. Once this happens, this is where I see many patients get rid of their years of back pain!
4) Whiplash injuries can TRIPLE the risk of future neck pain.
This is a BIG statistic for anyone that has suffered some form of whiplash. The main cause for this is lack of control of the neck following whiplash. Some treatment aims at fully regaining the movement at the neck, but sometimes the strength and stability parts of treatment are often overlooked. As such, it is extremely likely that if it is left untreated, that you will suffer from some form of other neck problem in the future.
5) Strengthening the shoulder helps reduce neck pain.
This follows quite a natural logic: some muscles of the shoulder attach up into the neck. Therefore, if there is greater support to the neck from below, it can help spread the load, and ultimately provide the neck with more support.
6) Core training doesn't improve low back pain faster.
This is probably the biggest "against the grain" comment to make. However, the research available to us now indicates that one particular form of exercise doesn't rule over another. It is more a concept of finding what you'd like to do, start small, and increase the frequency/intensity of that activity over a period of time. Focusing on core strength exercises like the plank, will, if anything, exacerbate this issue (see point 4) for the same reasoning. Bracing is a no go. General exercise and movement gets a BIG thumbs up!
7) Poor sleep quality worsen back/neck pain.
Studies have shown that those that get less than 6 hours sleep a night will have greater levels of the stress hormone, cortisol. As a result, with increased stress and little rest time for the body this leaves the body having to deal with being tired, stressed and in pain...the natural conclusion is that the body is going to let you know it isn't happy! This is where prioritising sleep and relaxation as part of a back pain treatment plan is important.
8) Poor Posture doesn’t cause back pain!
There has been plenty of research recently that widely accepts that we are all different shapes, sizes and postures...and it is now accepted that the body is a very clever piece of machinery and is able to deal with varying postures. If anything, someone who is making a conscious effort to correct their posture so that they are sat/stood bolt upright will probably have more of a problem than the person slouching on the sofa! The more important factors to address are: low activity levels, increased stress/anxiety, and lack of sleep. Sort these 3 things first, not your posture.