Low back pain (LBP) is the leading cause of disability worldwide, and is often associated with costly, ineffective and sometimes harmful care. What drives disability and poor care? Unhelpful beliefs about LBP are associated with greater levels of pain, disability, work absenteeism, medication use and healthcare seeking. Unhelpful beliefs are common in people with and without LBP, and can be reinforced by the media, industry groups and well-meaning clinicians.
Here, we identify some common unhelpful beliefs about LBP and outline how they may influence behavioral and psychological responses to pain.
BACK PAIN CAN BE SCARY, BUT IT’S RARELY DANGEROUS
Persistent back pain can be distressing and disabling, but it’s rarely life-threatening and you are very unlikely to end up in a wheelchair.
GETTING OLDER IS NOT A CAUSE FOR BACK PAIN
Although it’s a widespread concern that getting older causes or worsens back pain, research does not support this belief! Furthermore, evidenced-based treatments can help back pain at any age!
PERSISTENT BACK PAIN IS RARELY ASSOCIATED WITH SERIOUS TISSUE DAMAGE
Backs are strong, but if pain persists, it may be due to some other contributing factors. Back pain can begin with no injury or with simple, everyday movement or from an activity your body is not accustomed to.
PAIN WITH MOVEMENT AND EXERCISE DOESN’T MEAN YOU ARE DOING HARM
When pain persists, it’s common that the spine and surrounding muscles become really sensitive to touch and movement. The pain you feel during movement reflects how sensitive your back structure may be – NOT HOW DAMAGED IT IS. It’s safe and normal to feel some pain when you start to move and exercise; this feeling usually settles down with time as you become more active. In fact, exercise and movement are one of the most effective ways to help treat back pain.
BACKS DO NOT WEAR OUT WITH EVERYDAY LOADING AND BENDING
The same way lifting weights makes muscles stronger, moving and loading makes the back stronger and healthier. Activities like running, twisting, bending and lifting are safe IF YOU START GRADUALLY AND PRACTICE REGULARLY.
PAIN FLARE-UPS DO NOT MEAN YOU ARE DAMAGING YOURSELF
Pain flare-ups can be painful and scary, but they are not usually related to tissue damage. The common triggers are things like poor sleep, stress, tension, worries, low mood, inactivity or unaccustomed activity. Controlling these factors can help prevent exacerbation, and if you have a pain flare-up, try to stay calm, relax and keep moving!
INJECTIONS, SURGERY AND STRONG DRUGS USUALLY AREN’T THE CURE
Spine injections, surgery and strong drugs like opioids come with risks and can have unhelpful side effects. Finding low-risk ways to put you in control of your pain is the key.
Positive mindsets have been linked to lower levels of pain. Unhelpful low back pain beliefs may contribute to increase fear in participating in normal daily activities due to expected pain.
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