Common misconceptions about chronic back pain

If an exercise hurts it must be causing me harm

Not necessarily.

Some movements that human beings must do every day like standing or walking will stretch a painful, stiff, or shortened gluteal muscle. Physical therapists can teach you to get used to safe exercises for day-to-day movements.

By understanding that “hurt” does not always mean “harm,” you can slowly train your brain to not over-respond to the pain associated with these physical activities. Even though these exercises may cause more pain, this doesn’t represent damage or harm to your spine.

Bulging discs cause a majority of my back pain

Actually, no.

Many have been told their pain is coming from disc bulges or tears that look abnormal on their MRIs. Research shows that chronic back pain frequently does not correlate with the structural abnormalities that may appear on MRIs. Many people with disc degeneration, tears, and bulging discs are able to lead pain-free and active lives. 

Disc degeneration is a normal process. In fact, the blood supply to our discs was the best when we were teenagers. Every year afterward, the blood supply to the disc decreases. By the time we turn 40, many of us without back pain will have radiographic evidence of disc degeneration.

This process is completely normal. Our spines have the ability to adapt to new environments and activities. Studies have shown the disc actually benefits from increased physical loading and gradually adapts as joints, bones, muscles, tendons, and ligaments do.

My chronic back pain must have begun with an injury

Consider this:

Unless you undergo significant trauma to your spine, like being thrown out of a moving vehicle, the human spine is capable of absorbing a lot of energy without being damaged. By the time we develop chronic pain, our bodies have usually had several decades of wear before the first sign of back pain occurs. If one has neglected routine maintenance for many years, (such as maintaining a healthy weight, diet, and exercise habits) it makes the occurrence of problems like chronic back pain more likely. Acute back pain, the kind that accompanies a minor injury, usually heals within six months. 

I need to severely restrict my activity because I have back pain

Let’s rethink that conclusion.

We lose muscle strength and endurance much faster than we can regain it. Being off work or stopping our exercise deprives our bodies of physical activity for all of our muscles. Being able to take it a little easier while your muscle rebuilds itself is advisable, but long leaves from work or exercise deprive these deep muscles of the regular exercise they need in order to repair themselves. This is why keeping our muscles at their best flexibility, strength, and endurance is so critical. Regular exercise may actually have a preventive effect in terms of frequency of back pain and recurrence.

My back pain means something is significantly damaged or diseased

The chances are low.

In a study of 1,200 patients with acute back pain, less than 1 percent of patients with back pain had a serious condition including a fracture, infection, cancer, or multiple nerve root compressions. Several treatment guidelines can identify certain items in your personal history or examination that may lead us to suspect an underlying serious medical condition.

There has to be some form of sure-fire treatment for chronic back pain

Start by being a conscientious consumer.

Once reassured by your doctors that there is no fracture, infection, tumor, or a sinister medical condition that is responsible for your pain, the next step is to look for whether there are any factors that you can use to improve your pain condition.

Research shows back pain treatment to be one of the most-treated conditions in the United States. Consumers’ expectations are that this pain can be “cured” with a straightforward medication or procedure. 

Think back to the concept that chronic back pain is coming from overactive nerve or pain sensors that are amplified by the spinal cord or brain. Unfortunately, we cannot get into your deep muscles and spinal cord to adjust your microscopic pain filters without harming their various other vital functions. Our approach is to help you address the root causes of your pain by focusing on muscle flexibility, strength, and endurance.

Last reviewed: 
April 2018

Interested in using our health content?