Are back pain myths hindering your recovery?


Are back pain myths hindering your recovery?

Back pain is an almost unavoidable part of life.

1 in 6 people on the Northern Beaches are currently suffering from back pain of some description.[1] Back pain affects your work, sports, mental health, sleep and is a leading cause of disability worldwide.[2]

What if our attitudes and beliefs towards pain were also making it harder to recover from back injuries?

Studies have actually shown that how disabling back pain is to a person is more closely linked to their back pain beliefs, fear of physical activity and behaviours than the actual intensity of their pain.[3] These unhelpful beliefs about back pain are associated with higher levels of pain, disability, work absenteeism and medication use.[4]

The problem with unhelpful beliefs is that they too easily turn into often unhelpful behaviours. This makes the road to recovery longer and more painful. Behaviours such as avoiding normal spine postures (slouching while sitting) and meaningful activities (lifting, physical activity, activities of daily living and work) often lead to unhelpful protective behaviours such as muscle guarding, bracing core muscles and slow and cautious movement.[5]

Common back pain myths I’ve heard as a musculoskeletal physio

My back pain will be recurring and deteriorate as I get older

  • Even though lower back pain and back pain can be very painful quickly, with treatment from a great physio, pain can be reduced within a few weeks to months for most people.[6] Only a very small number of people develop long term or disabling problems when musculoskeletal therapy is sought early.[7]

Scans are always needed to detect the cause of back pain

  • Massive amounts of money are spent every year on X-rays, CT and MRI scans that benefit the prognosis and recovery of a very small number of people.[8] Scans can’t always determine the prognosis of back pain, the likelihood of future disability, or improve back pain clinical outcomes.

Back pain is caused by a weak core

  • Being weak in your core muscles alone isn’t the cause of your back pain. Recent studies have shown that there is no supporting evidencethat those with back pain have weak core muscles. Most likely is that any muscle deficit or atrophy is actually the result of back pain rather than the cause.[9] Learning to relax your core muscles during everyday tasks can actually be helpful, because being tense, or tensing your muscles for long periods of time is counterproductive.

If I have back pain I should stay in bed and rest

  • Avoiding aggravating activities for a few days after your initial injury should help to relieve pain. But, there is strong evidence that prolonged bed rest is unhelpful and is actually associated with higher levels of pain that last longer, greater disability and poorer recovery times. [10] Keeping active and returning your normal work, sport and hobby activities has been shown to aid recovery in the long run.[11]

Combining treatments to combat back pain

Depending on your specific type of back pain, your physio will usually recommend combined treatments for the most effective recovery. Combination programs have been shown to improve functions of the musculoskeletal system, resulting in reduced pain, reduced disability and improved quality of life.

Improving Spine stabilisation and keeping a correct posture can help keep back injuries at bay. [12]  Clinical pilates offers a highly targeted and researched methodology for targeting those core stabilisers. Strengthening the core through guided clinical pilates exercises can be the key to ensuring this process is maintained regularly.

Clinical Pilates sessions at Fixio are designed and run by experienced physiotherapists, experts in musculoskeletal function and rehabilitation. Clinical pilates at Dee Why has never been so personalised. Each session is conducted as an individualised program suitable for all ages and levels of fitness.

If you are suffering from back pain on the Northern Beaches and avoid seeing a physio, you are increasing your chances of your back pain persisting longer and a recurrence of the injury in the future. Don’t wait until the pain becomes severe or chronic, give Fixio a call and book in with a musculoskeletal physio.


[2] Foster NE, Anema JR, Cherkin D, et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet 2018;391:2368–83.

[3] Urquhart DM, Bell RJ, Cicuttini FM, Cui J, Forbes A, Davis SR. Negative beliefs about low back pain are associated with high pain intensity and high level disability in community-based women. BMC Musculoskelet Disord. 2008;9:148.

[4] Main CJ, Foster N, Buchbinder R. How important are back pain beliefs and expectations for satisfactory recovery from back pain? Best Pract Res Clin Rheumatol 2010;24:205–17.

[5] O’Sullivan PB, Caneiro JP, O’Keeffe M, et al. Cognitive functional therapy: an integrated behavioral approach for the targeted management of disabling low back pain. Phys Ther 2018;98:408–23

[6] Grotle M, Brox JI, Glomsrød B, Lønn JH, Vøllestad NK. Prognostic factors in first-time care seekers due to acute low back pain. Eur J Pain. 2007;11:290-8.

[7] Lehmann TR, Spratt KF, Lehmann KK. Predicting long-term disability in low back injured workers presenting to a spine consultant. Spine. 1993;18:1103.

[8] Chou R, Qaseem A, Owens DK, Shekelle P. Diagnostic Imaging for Low Back Pain: Advice for High-Value Health Care From the American College of Physicians. Ann Int Med. 2011;154:181.

[9] Wirth, Klaus, Hagen Hartmann, Christoph Mickel, Elena Szilvas, Michael Keiner, and Andre Sander. “Core stability in athletes: a critical analysis of current guidelines.” Sports medicine47, no. 3 (2017): 401-414

[10] Hagen K, Hilde G, Jamtvedt G, Winnem M. Bed rest for acute low-back pain and sciatica. Cochrane Database Syst Rev. 2009;

[11] Maher C, Latimer J, Refshauge K. Prescription of activity for low back pain: what works? Aust J Physiother. 1999;45:121-32.

[12] Lis, A. M., Black, K. M., Korn, H., & Nordin, M. (2006). Association between sitting and occupational LBP. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 16(2), 283-98.


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