Sunday, January 19, 2020

10 Helpful Facts About Low Back Pain

Favia Dubyk on her hangboard
Last week I discussed the myths about low back pain (LBP). This week I will write about 10 helpful facts about LBP once anything sinister and serious pathology are excluded. A positive mindset regarding LBP definitely helps with lower pain levels, disability and seeking healthcare.

Fact 1: LBP is not a serious life-threatening condition.

Fact 2: Most episodes of LBP improve and LBP does not get worse as we age.

Fact 3: A negative mindset, fear-avoidance behavior, negative recovery expectations, and poor pain coping behaviors are more strongly associated with persistent pain than is tissue damage.

Fact 4: Scans do not determine prognosis of LBP, the likelihood of future LBP disability, and do not improve LBP clinical outcomes.

Fact 5: Graduated exercise and movement in all directions is safe and healthy for the spine.

Fact 6: Spine posture during sitting, standing and lifting does not predict LBP or its persistence.

Fact 7: A weak core does not cause LBP, and some people with LBP tend to overtense their core muscles. while it is good to keep the trunk muscles strong, it is also helpful to relax them when they aren't needed.

Fact 8: Spine movement and loading is safe and builds structural resilience when it is graded.

Fact 9: Pain flare-ups are more related to changes in activity, stress and mood rather than structural damage.

Fact 10: Effective care for LBP is relatively cheap and safe. This includes: education that is patient-centered and fosters a positive mindset, and coaching people to optimize their physical and mental health (such as engaging in physical activity and exercise, social activities, healthy sleep habits and body weight, and remaining in employment.

There you have it. Quite different from what you have been told, read or heard. We seek to help patients confidently take up different postures, movement, graded loading physical activity, social and work engagement so you can live healthily. There are free educational resources to support these processes if you do have low back pain and have not seen us in our clinics.

You can watch this Youtube video or visit this site for more details. This will help reduce stress and build self sufficiency for you to better self mange your LBP and make better informed choices about your care.

In my next post, I will address how strengthening your 'core' (Transverse Abdominis and Multifidus) muscles was rapidly adopted by the Pilates, Physiotherapy and fitness community and if we should continue down that path.


Lin I, Wiles L, Waller R et al (2019). What does Best Practice care for Musculoskeletal Pain Look Like? Eleven Consistent Recommendations From High-quality Clinical Practice Guidelines: Systematic Review. BJSM. DOI: 10.1136/bjsports-2018-099878

O' Sullivan PB, Caneiro JP et al (2019). Back To Basics: 10 Facts Every Person Should Know About Back Pain. BJSM. DOI: 10.1136/bjsports-2019-101611.

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