Back pain: What’s the cause of your back pain? Five misconceptions debunked

Back pain is prevalent in the UK, with around one in three of people getting it every year. In most cases the pain is not caused by anything serious and will usually get better over time. However, conflicting and inaccurate advice can stop people from self-medicating and can turn a mild complaint into a chronic condition. It is therefore imperative to set the record straight.

You should never wait until the pain is too bad for you to walk

James O’Loan, consultant pharmacist

ccording to consultant pharmacist James O’Loan of Doctor4U, there are five dangerous myths in circulation:

“If you had a slipped disc, you wouldn’t be able to walk”

Some people with back pain are told that it can’t be a problem with one of their discs if they can still walk.

“However, this is an outdated idea and can cause much more harm than good. Because so many people believe that a herniated or prolapsed disc would cause such extreme pain, they don’t seek treatment for their symptoms, meaning that recovery can be delayed or incomplete,” explained O’loan.

In reality, if a person’s back pain is so severe that they lose the ability to walk, or notice weakness and numbness in their legs, it could be far more serious than a herniated disc, he said.

These symptoms can indicate a very serious underlying condition called cauda equina syndrome – where the nerves in the spine become so compressed that it can cause paralysis and incontinence, warned O’Loan.

“You should never wait until the pain is too bad for you to walk. Always see a doctor if you’re concerned about back pain that lasts for more than a few days, he advised.

“Bed rest is the best thing for a bad back”

One of the most common misconceptions about back pain is that bed rest can help with recovery.

As O’Loan explained, whilst moving can be painful, it’s important to keep mobile so that the back doesn’t become stiff and cause even more pain.

If the back pain persists past a few days, people should consult a physiotherapist, “as gentle and gradual movement is usually recommended for recovery,” he said.

O’Loan added: “A physiotherapist should be able to show you exercises that are tailored to the pain you’re experiencing, as well as showing you how to do them properly.

“There are only very few types of back injury where rest is encouraged.”

All back pain needs an MRI for a diagnosis

The trouble with things like back pain is that the lack of visible symptoms on the surface make it hard to know what is causing it, said O’Loan.

As O’Loan explained: “With surface wounds or broken bones, we can often figure out exactly what’s going on, but with something like back pain, it could be caused by a multitude of things.

“This can lead people to believe that the only way to diagnose their pain is to have an MRI scan. Unfortunately, this isn’t the case.”

Whilst MRI scans can provide valuable insight into what’s going on under the surface, a majority of people with back pain won’t need a diagnostic scan, he pointed out.

“In most cases, first-line treatment includes pain relief and physiotherapy, which is often all a patient needs to recover. It’s only in cases where initial treatments don’t work, or where symptoms might suggest something more than a strain or pulled muscle that an MRI scan can be useful,” explained O’Loan.

He added: “However, it’s important to know that in some cases, scans might not be able to show the source of the pain.”

All herniated discs need surgery

Luckily, this isn’t the case. In fact, the vast majority of prolapsed discs don’t require surgical intervention, noted O’Loan.

Most people find that with physiotherapy and pain relief, their symptoms subside within a few weeks.

As O’Loan explained: “Due to the nature of vertebral discs, they can move on a regular basis, and it’s common for bulging discs to settle back into place with first line treatments such as physiotherapy.

“It’s important to keep up with the exercises that you’ve been given, even if you feel better, as they encourage good spine health and can reduce the risk of reherniation.”

Surgery is only an appropriate course of action in cases where the herniated disc is causing red flag symptoms, or where it’s in danger of compressing the nerves in the spine, he added.

Opiates like codeine are the only pain relief that works for a bad back

Most cases of back pain can be remedied without resorting to opiates such as codeine and morphine, as other pain relief medicines are usually much more effective, said O’Loan.

As he explained: “Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen are often considered a first-line treatment for back pain to reduce inflammation that might be caused by a strain or injury, and for most people, this is often enough to manage their symptoms.

“Other treatments include muscle relaxants as well as non-medicinal pain relief such as TENS machines or an ActiPatch.

“Some severe cases of back pain might require opiates to relieve pain, but for the overwhelming majority, NSAIDs are enough.”

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