Seven common beliefs about back pain, checked against the evidence
Most back pain isn’t dangerous, but it’s rarely “nothing”. A lot of what people believe about it is out of date, and some of those beliefs slow recovery. Here are seven common ones, checked against current guidelines, and what to do instead.
1. “I should rest until it goes away.”
Bed rest makes most back pain worse; walking, even five minutes a few times a day, usually helps. Modify what hurts and keep what doesn’t.
2. “I need an X-ray or MRI to know what’s wrong.”
Usually not at the start. Imaging usually isn’t needed on day one; it’s ordered when the exam suggests it would change what we do. Scans also show changes in many people who have no pain at all, so a finding on a report isn’t always the explanation.
3. “It’s a slipped disc.”
Sometimes. Disc-related pain often refers into the buttock or leg and is worse with sitting or bending; joint pain is often worse standing or extending. The exam usually sorts this out without imaging. Most episodes involve some combination of joints, discs and the muscles guarding them.
4. “The pop means something went back into place.”
The pop you may hear during an adjustment is gas releasing inside the joint. It isn’t a bone moving back into position, and an adjustment can be useful with or without the sound.
5. “Once you start with a chiropractor, you have to keep going forever.”
No. How many visits it takes depends on how long it’s been going on and how you respond. You should get an honest estimate after the evaluation and an honest reassessment within a few visits. Most people know within a few visits whether care is helping.
6. “Hands-on care is either a miracle or useless.”
Neither. Research on spinal manipulation for low-back pain shows small-to-moderate improvements in pain and function, in the same range as other recommended conservative care, and clinical guidelines list it among the non-drug options to try first for acute and chronic low-back pain. Your response will be your own.
7. “If it’s this bad, I must need surgery.”
Severity of pain and need for surgery are different questions. Most back pain improves without it. If the evaluation suggests you need a surgical opinion, we’ll say so.
When to go straight to a physician
See a physician or go to urgent care today if back pain comes with any of these: new trouble controlling your bladder or bowel; numbness around your groin or inner thighs; weakness in a leg that’s getting worse; fever; unexplained weight loss; a history of cancer; a significant fall or accident; or if you’re over 70 with a new, severe onset.
What to do next
Keep moving, change position every 30 minutes if you sit for work, and give it a week or two. Book an evaluation if the pain is limiting what you can do, keeps coming back, has lasted more than two to three weeks, or runs into your buttock or leg. Our back pain page covers what’s commonly going on and what an evaluation looks like. Not sure which of these fits you? Take the 2-minute self-check.
Sources
- Low-Back Pain and Complementary Health Approaches, NCCIH
- Spinal Manipulation: What You Need To Know, NCCIH
- Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain, American College of Physicians clinical practice guideline, 2017
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Jim leads FIT Stretch and human-performance programs at Functionised; chiropractic care at FIT Clinic is provided by Dr. Michael Brandon, DC. Information on this site is educational and is not a substitute for an examination.
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