Back Pain Myths

Is there a role for massage in back pain?

There seems to be no harm following the first week, however, there is little evidence that shows massage aids in a speedy recovery.

What about the evidence for laminectomies?

A laminectomy is when the lamina (the back bit of the vertebrae with the spinous process) is removed. Frequently a cage, or connecting rods are the placed to stop the vertebrae from moving. Laminectomies do work well and reduce pain when there is pressure on the nerves that comes from this bony section. But for general back pain, the evidence is poor; depending on how long the patient has been in pain for and the psychological state of the patient. Unfortunately, the results the patient want and what the doctor expect are different.

How do you cope with muscle spasms with acute back pain?

Muscle spasms are related to an irritated nerve. A muscle relaxant such as diazepam can be used in the very short term. It should be used with paracetamol, an anti-inflammatory, heat pack and gentle movement. If the muscle spasm continues, adjustments to the medication regime can be made to include Phenergan, which works as a great nerve suppressant.

Are there any supplements that are good for back pain?

There is conflicting evidence on just how helpful fish oil and other supplements are in assisting back pain. Post of the large, randomised control studies (considered to be the best type) do not find much improvement in pain or function with the use of supplements.

How do you work on core strength?

There are many ways to get information on this, via videos on line, web sites and books. A physiotherapist will give you many exercises and guide you in doing them correctly.

Is there evidence for back extensions?

There is evidence, but only to increase the large muscles for display. Most of the core muscles are small muscles acting as stabilisers where back extensions increase the pressure on the disc.

Are Yoga and Pilates or any other stretching movements good solutions for back pain?

Yes, they are very important. Yoga and Pilates can assist with increasing strength and correcting neuromuscular activation to turn on in the right sequence. This assists with prevention and in many cases, relieve lower back pain.

Is some back pain caused by muscle imbalance?

Physiotherapists would suggest this to be true. Muscle imbalance can cause the pain by having one set of muscle working too hard compared to the other. If the muscle imbalance is not the cause of the pain it may increase risk of injury and so, needs to be addressed. However, this also needs to be assessed and addressed by a physiotherapist through a range of stretches as well as a core-strengthening program.