Myth #1: I need to rest my back if I injure it.

Rest was once considered the first line of treatment for anyone who underwent a back surgery or back injury. While resting does help decrease inflammation, most patients rest too much and for far too long, which can actually make things worse. By resting, you are allowing your muscles to become stiff and weak. Which can increase the risk of further injury. Our discs hold nutrients and without movement they lose fluid. I had a professor once say, “motion is lotion”. Our bodies crave movement and movement keeps our discs healthy.
Research has shown that 1-2 days MAX of resting is all that is needed after an acute back injury. So get up. Walk your dog. Go to the grocery store. Any movement. Finding ways to move, even small, is considered best when it comes to managing back pain. Remember “motion is lotion.

Myth #2: Once injured, always injured.

Some people think that once they injure their back once, they are stuck dealing with it forever. But that is not the case. Staying active, finding healthy exercises, learning proper lifting and bracing techniques, and eating healthy are all actions you can take for good spine health and keeping back pain away for good.

Allowing yourself to buy into this myth can actually keep you from feeling better overall. A person’s belief, perception, and mindset on their back pain is a top predictor of their recovery.

Myth #3: My MRI showed my back is all jacked up. I must need surgery.

MRI’s are helpful tools in understanding what the actual issue is in our tissue, but can also tell us more than we need to know or be misleading. I typically only suggest patients get an MRI if they have a severe loss of function or conservative treatment has been attempted for an extended period of time (at least 1 year) and failed. MRI’s do not need to dictate our treatment but can be used together with patients reports of pain and function.

For instance, a study revealed that in a group of people without symptoms, MRIs showed:
           36% had herniated discs
           21% had spinal stenosis
           90% and degenerated or bulging discs
           
Another study performed MRI’s on non-symptomatic patients and then again after an incidence of low back pain was reported. 84% of the patient’s MRI’s were unchanged or had improved after their injury!

These studies show us that MRI findings do not always match with our symptoms. Many times, people allow MRI findings to dictate their feelings and overall outcomes of their back pain.

Myth #4: I can’t lift heavy things because of my back pain.

This does not mean that people with back pain and injuries should go out and lift as heavy as they can with no thought behind it. But people shouldn’t AVOID lifting and strengthening exercises because they “have a bad back”. When in fact, lifting can and SHOULD be a part of low back pain rehab. It has been proven in research that exercises, such as the deadlift (my favorite), when properly taught and dosed, greatly decreases peoples reports of pain, increases function, and increases quality of life. 

What is even better in the research articles, is that people were prescribe exercises at an appropriate dose. They were doing 6-10 rep max weights (not therabands and ankle weights you see in typical physical therapy), but actual heavy weights!

Imagine that, when we learn proper form, correct bracing and appropriate dosing, lifting heavy can be therapeutic. 
Most of us will experience low back pain at some point in our lives. Being able to have a better understanding of the nature of treatments that will help you when and if the time comes is important. Don’t allow yourself to fall into old thinking and don’t allow yourself or other healthcare providers to keep you from moving and staying healthy for life. Most importantly, if you have back pain, KEEP MOVING. Motion is lotion. You are not a fragile human. You are resilient and you will get better. Don’t let imaging scare you into a premature surgery. You are not your image. Lift well and lift heavy. 

References:
Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am.  1990; 72: 403– 408.  [Crossref] [Medline] , [Google Scholar]
Welch N, Moran K, Antony J, et al. The effects of a free-weight-based resistance training intervention on pain, squat biomechanics and MRI- defined lumbar fat infiltration and functional cross- sectional area in those with chronic low back. BMJ Open Sport Exerc Med 2015;1:000050. doi:10.1136/ bmjsem-2015-000050 J Orthop Sports Phys Ther. 2015 Feb;45(2):77-85, B1-4. doi: 10.2519/jospt.2015.5021.
Individualized low-load motor control exercises and education versus a high-load lifting exercise and education to improve activity, pain intensity, and physical performance in patients with low back pain: a randomized controlled trial. Aasa B1, Berglund L, Michaelson P, Aasa U.