SPECIAL FROM Next Avenue
By Linda Melone
Approximately 80 percent of Americans can expect to experience back pain at some point in their lifetimes. If you find yourself hurting and decide to search online for “back pain solutions” you’ll find reams of information — some of it contradictory and even harmful.
Check with your doctor if you're having pain. And listen to what top experts say about the most common back pain myths and what really works.
Myth No. 1: A fitness ball is better than an office chair for your back.
Reality: The idea of sitting on a cushy ball instead of a traditional office chair seems like an easy way to strengthen your core and ease back pain, but the lack of support can be less than ideal. “Plus, simply sitting on the ball does not automatically activate your core,” says Nara Yoon, a physical therapist practicing in Manhasset, N.Y.
Using your core involves consciously engaging your core muscles, as well as finding the right size ball and practicing proper posture. A ball should enable you to sit with your thighs parallel to the floor.
“If it’s too small your hips will drop below your knees and promote a slouched posture,” says Yoon. In addition, posture may suffer once core muscles fatigue. If you decide to try a fitness ball, alternate it with a traditional office chair throughout the day, and especially at the first sign of back fatigue.
Myth No. 2: You should always get a massage.
Reality: When you’re in pain, a massage may help in some cases and hurt in others, depending on the cause of the back pain. “For instance, the lower back may feel tight because of a muscle spasm occurring in an unstable region, for instance in the case of sacroiliac joint (a joint in the pelvis joined by ligaments) dysfunction,” says Yoon.
A massage to this area without truly assessing the source and the reason for its tightness can inhibit the body’s way of protecting itself and cause more instability, thereby causing more pain, says Yoon. Chronic, common lower back pain involving stiffness of the muscles and joints, on the other hand, may benefit from massage. See a doctor if you’re unsure of the nature of your pain.
Myth No. 3: Stretching relieves back pain.
Reality: Like getting a massage, stretching when you’re unsure of the cause of your back pain could cause more damage, says Yoon. If the nerve from the spine is inflamed, as in the case of an intervertebral disc injury, stretching the quadriceps and hamstrings (which normally helps relieve back pain) can cause more damage.
“The positions for those stretches will also stretch the already inflamed nerve, causing more pain,” says Yoon. Avoid these stretches until the symptoms subside. If the pain results from mechanical reasons (pain caused by normal stress and strain of back muscles) stretching may help, however.
Myth No. 4: A hot bath reduces back inflammation.
Reality: It may sound soothing, but getting into a hot bath when muscles are inflamed can make matters worse by increasing the inflammatory response in an acute injury. “Generally, it is better to [immediately] apply ice to an injury for 15 to 20 minutes (not directly on the skin) during the first 48 to 72 hours after the injury,” says Yoon.
However, chronic pain (pain lasting longer than 12 weeks) not accompanied by inflammation can be eased with a hot bath or hot pack.
Myth No. 5: It’s best to lie down until the pain goes away.
Reality: Lying down until the pain goes away can work against you and may even slow healing, says Dr. Jeremy Smith, spine surgeon with Orthopaedic Specialty Institute Medical Group of Orange County in California. “Bed rest is not recommended, although you should reduce normal physical activities but continue to be as active as possible. Those who stay active recover more quickly,” says Smith.
A study published in the Annals of Internal Medicine involving 134 workers with back pain found that those who exercised during their recovery time took 58 days to return to work, versus 87 days for those who did not.
Myth No. 6: Most back pain eventually requires surgery.
Reality: If you’re afraid to see a doctor to treat your back pain for fear you’ll need surgery, chances are you’re worrying needlessly.
“The overwhelming majority of patients that have an episode never require surgery,” says Smith. “Most back problems are treated with non-operative measures, such as activity modification, anti-inflammatory medications and physical therapy.” Activity modifications typically include avoiding twisting motions, prolonged sitting and heavy lifting.
Myth No. 7: Back pain often occurs without warning.
Reality: A sudden case of your back “going out” on you may seemingly occur out of the blue but often times may be related to poor conditioning, weight gain, incorrect posture, and poor lifting mechanics.
“The cumulative effect of these may result in an acute back pain episode that often occurs with the simplest of movements,” says Smith. Sudden pain may also be a sign of an underlying degenerative process with the disks or joints of the spine that predisposes a person to frequent back pain episodes, says Smith. See a doctor if back pain is accompanied by weakness or bladder control issues, which may indicate a neurological issue that requires addressing.
Next Avenue contributor Linda Melone is a California-based freelance writer specializing in health, fitness and wellness for women over 50.