For many people, the approaching warmer weather will mean being more active. Longer days, fresh spring air and warm temperatures are good motivators for exercise, whether your preferred method is walking or joining a local baseball league.
But not everyone has the same enthusiasm for physical activity. While people with chronic back pain may want nothing more than to be more active, it may seem as though pain takes exercise off the table.
Obviously, being in pain makes movement hard. But for chronic pain patients, the biggest barrier to physical activity may be in the mind – in misconceptions about pain, movement and rest. These misconceptions are counterproductive, since movement is an imperative part of back pain recovery. The following common misconceptions may be getting in the way of your recovery.
1. If it hurts, I shouldn’t do it.
Now, sometimes this is true. If it hurts to bend because of a disc herniation and you’ve been instructed by a medical professional not to bend, then you shouldn’t bend. If it hurts to lift a heavy object while twisting, it’s because this is an example of improper body mechanics and you shouldn’t do it.
Whatever the cause of your back pain – muscular, disc-related, etc. – you’ll likely experience pain with a wide range of movements. Your back is involved in nearly every move you make. If you stop all movements that hurt, you aren’t likely to move much at all.
If you have an identified spinal problem, you should carefully heed a physician’s advice about physical activity. If your pain is nonspecific (with no identifiable cause), you aren’t likely to be causing any actual harm to your back by doing daily, moderate activities with proper body mechanics. Sometimes, you just need to move through the back pain.
2. If it hurts, it means I’m doing damage.
This misconception is intimately related to the first one. Like the first one, though, the idea is sometimes accurate. Paper cuts hurt because the skin is being damaged, for example. But the cause/effect relationship isn’t quite as neat with back pain.
Researchers are increasingly becoming aware of the presence of nervous system maladaptations in patients with chronic pain. The nervous system can interpret harmless stimuli as harmful and process them as pain signals, causing you to feel pain for seemingly no reason. The nervous system may “learn” this pattern after being exposed to constant painful stimuli, or the reason may be unknown. This maladaptation can occur in the form of nerves sending faulty signals to the brain or the brain interpreting signals incorrectly.
Nervous system maladaptation may be a cause of fibromyalgia. The literature on its role in chronic back pain is mixed, but there is a good chance that, for some patients, it plays a role. See a review of the literature at www.ncbi.nlm.nih.gov.
3. When I hurt, I should rest.
As with #1 and #2 above, this idea is sometimes legitimate. If you’ve been relatively active and are starting to feel sore, take a rest day. But if you hurt all the time, the recourse to rest can lead to muscular atrophy, joint stiffness and decreased cardiovascular health, all of which spell worsened pain and increased likelihood of chronic illnesses such as heart disease and type 2 diabetes. A paper published by a team of three doctors reports that, with each day of bed rest, muscles lose between 1% and 3% of their strength, and three weeks of bed rest result in a full 25% reduction in aerobic fitness. See more on this at www.desertspineandsports.com.
Getting a healthy amount of physical activity starts in the mind. Learning about common misconceptions concerning lower back pain can help you avoid sabotaging your recovery.