Back and Neck Pain a paradise of myths

For a vast majority of us, Back and Neck Pain is a fact of life. The timescale of it may vary, but it does visit each of us at some point of time in our lives. Fortunately, majority (90%) of them will resolve on their own in 2-3 weeks, during which symptomatic treatment and physiotherapy is the mainstay of treatment aimed at maintaining range of movement during the episode. Back and Neck pain is an epidemic of modern day society and not surprisingly, conflicting messages are bound to contribute in spoiling the broth. The scale of the problem in a diverse society, with multiple professional contributing in the care, is bound to feed confusing and conflicting messages. The aim of this article is to present commonly encountered myths among my patients of back and neck pain.

Myth 1

“I can’t get back/ neck pain, I am way too healthy for it”

As I said in the introduction, nearly 70- 80 % of us will suffer with it at some point in our lives, even if it is for short period lasting days / weeks. Having a balanced range of activities to strength all muscle groups is the key.  Even athletes / sportspersons are affected if the sport involves excessive strain on a certain muscle group or body part. Habitual body posture / activity predisposes for injury or pain.

Health tip: Prevention is better than cure. Practicing good technique for our daily activities like sitting, standing, walking, lifting contributes in keeping pain at bay.

Myth 2

“My back / Neck hurts, I need bed rest”

The current consensus for optimal course of action is to stay as active as is feasible. Any extended periods of rest beyond 2-3 days, sows the seeds for persistent chronic pain (greater than 3 months). It is reasonable to modify your activities, but avoid taking complete bed rest. Attempt to return to your daily routine activity.  The health and strength of posture supporting muscles around your spine are just as important as your spine bones. Scientific studies have demonstrated weakening of your back muscles after just 2 days of rest (disuse atrophy). So, it time to jump (I mean climb) out of bed and attempt to return to your daily routine as much as possible.

Tip: Minimise any rest period and attempt return to daily routine.

Myth 3

“I have to give up my favorite activity like sport, jogging, etc”

Your back pain may act as a dampener to your intentions to continue your desired activity. Your doctor / physiotherapist will guide you in an individually tailored exercise regime to assist returning to your favorite activity. A combination of flexibility exercise, core muscle exercises, and appropriate posture will assist you in returning to most or all of your favorite activities.

Tip: Adapt rather than sacrifice your favorite activity and sport.

Myth 4

“I need an xray or scan to find out the cause of my back and neck pain before starting treatment”

Majority of back and neck pain episodes get better on their own with symptomatic treatment and scan should not delay the onset of treatment. In most situations, further investigations are required when pain does not get better after 2-3 weeks. Your doctor is the best placed to assess the need for scan.

Tip: The professional’s assessment and advice should guide your treatment plan.

Myth 5

“My scan and x-ray will find the cause of my pain”

The sophisticated scan provide nice images of your back / neck that might show an abnormality. However, such changes are a common (30-40%) in over 40 year olds people routinely carrying non-painful spine changes. However, your doctor is best placed to guide you in correlating your pain pattern with your scans. It is fairly common to not identify a specific cause on your scans for your pain. After all, the body does not live all day lying flat like in the tunnel of the MRI scanner. The constant weight bearing, strain of posture and movement are something that can’t be replicated in any scanner.

Tip: Your tests will guide and supplement the professional’s meticulous assessment, but can’t replace it.

Myth 6

“I have back / neck pain, and I need surgery”

The indications for surgery for back and neck pain are very few, and only a small proportion of people need it. You would need to be assessed in detail before considering surgery, usually to relieve pressure on nerves (not irritation of nerves). There are many simple treatment options including minimally invasive procedures that may be suitable before considering surgery as a treatment option.

Myth 7

“I have always been overweight, how can this be the cause of my back pain”

The skeleton supported by its ligaments and muscles carries all your weight. Any weight you carry squeezes the disc in your spine and hence does correlate with pain. Moreover, a large belly tilts your pelvis forwards making an abnormal curve in your spine. This can contribute in causing your pain. Any exercise you undertake in reducing your weight has an added benefit of promoting production of endorphins (body’s own painkillers).

Tip: Reducing weight and maintain it have multiple ancillary benefits like sense of wellbeing, self-confidence, improved muscle endurance and activity tolerance.

Myth 8

“Back and Neck pain is a very disabling condition”

Excessive fear and unwarranted misinformation will harm your chances in helping yourself. Staying motivated, leading a healthy lifestyle, maintaining active lifestyle and social engagements. People who return to normal routine activities without excessive rest or overdoing exercises will fair better in the long run.

Tip: How you adapt and accommodate to your medical condition determines the severity of disability.

Myth 9

“All the heavy lifting, I have been doing and continue to do is bad for my back and neck”

Lifting with knees rather than your back is the key message in lifting hygiene. It is more about how you lift, than how much you lift. Of course, excessive weight, does mean more chances of back and neck pain. Having the right help, aids and lifting technique will keep you in good health.

Tip: Often poor lifting hygiene rather than lifting weight is the culprit.

Myth 10

“No doctor can find the cause for my pain, it is all in my head”

Pain is real and pain is what you say it is, irrespective of what the tests and doctors say. You need assessment by a qualified professional (like pain physician, rheumatologist, neurosurgeon, orthopedician). Pain experience has many dimensions inclusive of an emotional component that drains a lot of energy and motivation. You need help with a meticulous assessment and guidance from an experienced professionals to guide you in your fight against pain.

Summary: Back and neck pain are inevitable short term visitors in our lives (self or relatives). For the unfortunate few left with chronic pain, a plethora of misinformation contributes to the suffering and experience of pain. A plethora of myths accumulated along the way do more harm than good for this long term condition. High quality evidence based treatments are now available, many without the need for surgery. Getting the right qualified help and advice in your fight against persistent back and neck pain is the best thing you can do for yourself.

Blog by

Dr. Hirachand S Mutagi.
Senior Consultant in Pain Management.
Dept. of Interventional pain Management.
Sakra World Hospital.