Myths of Low Back Pain
Low back pain is a complex problem that affects many of us. It has often been greatly simplified by medical professionals to make problems easier to understand. Unfortunately, this has led to a lot of confusion around some medical terms. This post is designed to dispel some low back pain myths.
1. A “slipped disc”
This term gets used all too frequently, and can be quite confusing. From a medical point of view, it makes very little sense as discs cannot ‘slip.’ Vertebral discs are anchored securely between the segments of the spine and act as a ‘shock absorber.’ The disc itself is comprised of a soft centre called the nucleus, which is surrounded by a strong thick ligament called the annulus. The disc itself cannot move or ‘slip.’ What actually occurs in a ‘slipped disc’ is the soft inner nucleus has burst through the outer tough ring. This is called a ‘disc prolapse’ or ‘herniation.’ This can happen and produce no pain or symptoms at all, however more severe prolapses can cause severe low back pain, pain into the legs, and in more extreme cases, muscular weakness and power loss.
2. Sciatica
Sciatica is often used as an umbrella term for pain in the back of the leg. This is not completely true, as sciatica is actually a specific medical condition. True sciatica is caused by compression or irritation of the large sciatic nerve, which runs down the back of the leg and supplies many muscles in the leg. Sciatica can be caused by a variety of reasons (e.g. disc prolapse) but pain down the back of the leg is not always caused by sciatic nerve irritation. It can be caused by irritation to the small joints in the spine, (facet joints) irritation to certain pelvic joints (sacroiliac joints) or by the large muscles in the back of the thigh that are collectively known as your hamstring muscles.
3. Core strength
In the 1990s it was believed that core strength could prevent and alleviate lower back pain. This rested on the belief that a strong core was required to support and stabilise the spine, and that without good core strength you are more likely to injure your back. However in 2007, an article by Dr Lederman assessed the current evidence and thinking behind core strength. Dr Lederman concluded that core strength wasn’t really that important. General activity was shown to be just as effective as core-focused exercise in managing low back pain. When patients ask me about the importance of exercise, I usually encourage them to take up a sport/activity they enjoy and are likely to stick to long term. I recommend yoga, pilates and swimming in particular, as they provide a great workout that is easy on the joints. This means that you can stick with these activities as you get older, and can remain active for as long as possible.
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