Myths about back pain

The nervous system is very protective of the back. The back can hurt even when it is not damaged. If you do damage it, you will know about it at the time. If you have had pain in the past, then returned to normal activity, it shows that the back healed (the back cannot hide things from you).

Research shows that people who are more careful with their backs are more likely to have ongoing problems. Even if you were doing something in particular when the pain began, you can still do it again in the future.

Being careful stops you from using the back normally. Movement helps the back to stay healthy. Being careful can also stop you doing many things you enjoy, or stop you enjoying the things you do.

Muscles are important for moving the back, but they are not needed to support it. The back’s basic design can do that all on its own. Research shows changes in muscle strength do not relate to changes in back pain. 

Exercise is good for you because it stimulates your brain and your whole body, not because it makes the back stronger.

The joints in your back are held together by a vacuum and cannot be separated without significant force (like a car crash). If such a thing were to happen it would be very clear, as you would be paralysed. There is no evidence that back pain is caused by bones or joints being out of place. Clicks are just due to a change in pressure within the joint, not the bones moving into, or out of, place.

The discs in your back are made out of cartilage, like the hard part of the outside of your ear. They are fused to the bones above and below, and are surrounded by strong ligaments, so they cannot move out of place. 

Discs can bulge a bit, but this does not necessarily cause pain. A scan of your back may show a ‘disc bulge’. But it’s hard to say the bulge is the problem because bulges are also often found in people with no back pain. Most bulges shrink over time without any treatment.

The brain makes pain, and it hurts wherever the brain thinks the problem is. This is easy when it is on the skin, but less so when it is on the ‘inside’. Leg pain means that your brain’s best guess is that part of the problem is in your leg. If your nerve is pinched you will have weakness and numbness, as well as pain. Your doctor will also notice changes in your reflexes.

Sitting has been blamed for a lot of back pain. There is now very good research showing that sitting is not a problem for the back. How could you injure yourself sitting in a chair?

People often say that the back is not designed for sitting. However, there is actually no time in our evolution when we have not sat. The great apes sit a lot, cavemen had to do something when the sun went down. It would be silly for our backs not to be designed to do something which we have spent all of our history doing.

Our backs have actually evolved a long way from when we were apes and spent a lot of time on our hands and feet.

Part of our evolution has been the development of a double arch in our spine. Arches are very strong, and this system means the weight of our heads and trunks is passively passed through our backbones and into our legs or buttocks (depending on whether we’re sitting or standing).

There is actually no link between posture and back pain. There may be other reasons for wanting good posture (performance, appearing confident etc.), but protecting your back does not need to be one of them.