Tag: MRI scan Lower back

Back Pain Myth Busting Part 1

This series of blogs is to help bring some clarity with what to expect with back pain and what the evidence is telling us.

This week I wanted to pull out some facts regarding back pain and the public perception of the most prevalent musculoskeletal injury. The idea is to give you more confidence in using your back during injury but also trying to clear the stigma associated with this condition.

 

1 Back Pain is normal factor in life

Up to 84% of people will have some form of back pain in their lifetime (1). It has become inevitable that this will happen at some point unless you’re a hermit. The good news is that only a small percentage that don’t fully recover.

Most acute back injuries are the result of a simple strain or sprain and expected recovery is excellent. Within the first two weeks of an acute episode of pain, most people will report a significant improvement in their symptoms with up to 90% full recovery within 6 weeks. Only 2-7% of people develop chronic, disabling problems (2).

2 Scans are rarely needed – be careful what you wish for

This one is great, if you put the people of Newmarket through an MRI scan about 60% will have some abnormality even if they don’t have pain. (3, this wasn’t a study of the Newmarket population) (4)

Wait, so if an MRI scan can show a disc prolapse without pain, could that mean the pain may not be associated to the disc identified? Some of us need a “label”, once being diagnosed with a disc prolapse it becomes easy fall back into the “what can I do? I’ve got a disc prolapse”. This can cause a heightened fear of moving normally and exercising, which happens to be the opposite approach to rehabbing this condition. (5)

Consider this, only 5% of lower back strains are the direct result of a disc herniation (6). It’s not to say they can’t be the cause of pain but there are many other structures and factors involved with lower back pain.

  1. Balagué et al, (2012) Non-specific low back pain. Lancet.
  2. Kinkade, (2007) Evaluation and treatment of acute low back pain. Am Ac of Family Phys
  3. Jensen et al, (1994) Resonance Imaging of the Lumbar Spine in People without Back Pain, N Engl J Med
  4. Teraguchi et al, (2013) Prevalence and distribution of intervertebral disc degeneration over the entire spine in a population-based cohort: the Wakayama Spine Study.
  5. Shnayderman et al, (2013) An aerobic walking programme versus muscle strengthening programme for chronic low back pain: a randomized controlled trial. Clin Rehabil.
  6. Lateef et al, (2009): What is the role of imaging in acute low back pain? Curr Rev Musculoskelet Med