6 Surprising Facts You Might Not Know about Low Back Pain

March 8, 2020

by Cathe Friedrich

Ouch! Low back pain can make you wince when you move and make it hard to carry out your daily activities. An achy, stiff back has a variety of causes including a muscle or ligament strain, arthritis, disc disease, and several other medical conditions, including injuries, tumors, anatomic abnormalities, and infections that can trigger low back pain. So there isn’t a single cause of a sore or stiff back but that doesn’t make it less of a burden on society. It’s a problem that leads to 264 million lost workdays per year. Here are six other facts you might not know about low back pain.

Low Back Pain is Common!

How common is pain in the lower back? Research shows that up to 8 out of 10 people will experience low back pain at some point in their life. Some people complain of short-term back pain because of a strained muscle, but for others, back pain is a chronic problem. Back pain that lasts longer than 3 months is considered chronic, and it can be a recurring problem that cycles back and forth over many years, leading to frustration and lost productivity.

The Cause is Often Unknown

If you have chronic low back pain, your health care provider may order imaging studies to look for degenerative disk disease or a herniated disc, but in 85% of cases, imaging won’t show a cause. An MRI may show a herniated disc, but studies show that even in people who have a herniated disc, the disc causes the pain less than half the time. Most times, imaging studies are normal and there is no established diagnosis but that doesn’t make it easier to deal with!

Ergonomic Factors May Play Only a Small Role in Low Back Pain

You may have heard that how you sit at your desk at work and other ergonomic factors cause some back and neck pain. However, research doesn’t bear this out. Studies looking at changes in how long people sit and how they sit in a chair, whether they sat straight up or slumped, show little relationship to back pain. We hear about how important good posture and ergonomics are but having an ergonomically friendly chair and desk and sitting up straight doesn’t mean you won’t have a sore back. As PainScience.com points out, “There are many people with nice posture who are in terrible pain and many people with lousy posture with no pain.” Slouching isn’t good for other reasons, but it may not be a major contributor to back pain.

The Work You Do Matters

Sitting in a chair with bad posture may not be a huge contributor to lower back pain, but the work you do increases the risk. One study found that people who lift heavy objects on the job are at higher risk of developing an achy back. In fact, almost 40% of lower back pain cases are related to lifting on the job. People who lift loads greater than 55 pounds daily have a 25% greater risk of developing lower back pain. On the plus side, an exercise that focuses on strengthening the core muscles lowers the risk. So, strength train in a controlled manner to strengthen the muscles in the back has benefits, but repetitive lifting on the job using poor form is harmful.

Rest Isn’t the Best Treatment

Many people try to doctor back pain at home with heating pads and rest, but studies show that exercise is a more effective treatment for lower back pain than resting. In fact, a lack of movement causes muscles to decrease in size and strength due to lack of use. Plus, not moving for even short periods of time can increase muscle stiffness.

Research shows a combination of strengthening, flexibility exercises, aerobic, and core exercises are best for treating lower back pain. Why aerobic training? When you boost your heart rate, it boosts blood flow to the muscles in the lower back. This increases oxygen and nutrient delivery to the muscles in the back to promote healing.

It’s not surprising that core strengthening helps lower back pain. Studies show that programs that strengthen the muscles that stabilize the back, including exercises like planks and other concentric moves, are as effective as Pilates and yoga for preventing lower back pain.

If you suffer from severe or chronic back pain, it’s best to find a physical therapist who can help you select the best exercises that won’t place added stress on the back and monitor your form. Then, you can do them at home on your own. Strength training is an important component of preventing future back pain since it strengthens the muscles that support and stabilize your spine.

Most Commercial Products for Back Pain Aren’t That Effective

One of the more popular products that people use to treat lower back pain is a back brace. However, research doesn’t support the benefits of wearing a back brace. In fact, an analysis of multiple studies showed mixed benefits and most studies that show effectiveness are of poor quality.

Another popular back pain treatment is to wear shoe insoles that support the foot. The theory behind wearing these is that lower back pain can be aggravated by foot and ankle problems. Plus, ankle and foot problems can also throw off a person’s gait, and that places excess stress on the back. It makes sense since all structures in the posterior chain are connected. However, not all studies support the benefits of even custom-made insoles. Even the studies that suggest benefits show only modest improvement in symptoms.

The Bottom Line

Lower back pain is real, and it’s a chronic problem for some people. Some of the interventions that people think help the problem, like wearing a back brace or insoles, don’t hold up to scientific scrutiny. However, controlling your body weight to avoid obesity and strengthening the muscles that support and stabilize your spine can help. Talk to your doctor before starting a strenuous exercise program though.

References:

American Family Physician. Volume 100, Number 11. December 1, 2019.
Gordon R, Bloxham S. A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare (Basel). 2016;4(2):22. Published 2016 Apr 25. doi:10.3390/healthcare4020022.
Spine-Health.com. “Shoe Insoles for Lower Back Pain”
com. “Does Posture Correction Matter?”
National Institute of Neurological Disorders and Stroke. “Low Back Pain Fact Sheet”