Is bending my back dangerous?
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It is important to understand that when you have back pain, while it can be horrendously painful and disabling, in the vast majority of cases (more than 90%) there is no structural damage.
What causes back pain?
Back pain is usually the result of a combination of factors coming together. These can include a mechanical force such as a fall or direct impact. But, what is really important to understand is that other factors can pre-sensitise your nervous system. This can make it easier for an innocent action to set off pain as a response. These can be elements of your general wellbeing such as your mental health and stress levels, sleep quality, physical activity and your beliefs about your back pain.
With about a third of all back pain the individual cannot identify any physical event that triggered the pain. If we compare our reaction to back pain to when we have a headache, we would not fear that we have damage in our head unless we have had a physical event to cause it. Why is back pain considered so differently?
It is less than 1 in 10 (about 5-9%) of all back pain that is caused by an injury to a specific structure that might be a disc. And even more rare (less than 1%) is caused by a serious pathology such as a fracture, an infection or cancer.
What should you do?
If we don’t have structural damage, being overly protective or guarded with movement is not helpful for recovery. If you sprained you ankle the best treatment is not to put it in a cast to protect it but to get is moving as soon as possible, and gently return to your normal activities. And it is the same for back pain.
Tightening the muscles of your back and your abdomen to protect your back can be the automatic response. But, this adds more stress to your back and can actually accentuate the pain you may feel. An expert in the field of back pain, Peter O’Sullivan, uses the example of experiencing the movement of your wrist while you hold your fist clenched tightly. Try moving your wrist in circles which clenching your fist. It doesn’t feel very comfortable does it? And you can see how much harder it is to move and how limited the movement is.
Is bending dangerous?
To get back to the question of bending… No, it is not supported by research that bending is bad for your back. Nor is it that holding your back straight is good for your back. Our back is designed to move in a range of directions and it gets stronger with use and loading. If you have pain, you may need to tone things down a little for the short term but it is the gentle mobility and gradual return to activity that will get you better. Bed rest for back pain is archaic advice and is not helpful.
Here are two great websites with lots of good and very useful information:
http://www.pain-ed.com/ & https://painhealth.csse.uwa.edu.au/
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If you would like to discuss this with on of the Flawless Physio team please get in touch.
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