10 misconceptions about back pain

Having your back “cracked” is a relief, sleeping on a hard mattress is good for your back, flat shoes should be preferred in the event of lower back pain… Preconceived ideas about back pain die hard. What are the good and bad tips to really remember when you suffer from back pain? Answers and clarification with Dr. Steffen Queinnec, orthopedic surgeon and traumatologist.

Misconception 1: You can move a vertebra on your own

FAKE. A vertebra does not move as a result of an accident, false movement or manipulation. “Moving a vertebra manually is strictly impossible from an anatomical point of view. We may possibly hear about “vertebra slippage” or the medical term “spondylolisthesis”, but it is something that is due to the repetition of mechanical stresses on the spine and which is built up little by little and very slowly. And in this case it is very difficult, even surgically, to put the vertebrae back in place”, warns the specialist.
• Saying that you are having a vertebra put back in place when you go to the osteopath is just as wrong.

Myth 2: Cracking your back relieves pain

FAKE. Having your back cracked (alone or with someone) is absolutely not recommended : only professionals can correctly perform this manipulation, and you risk hurting yourself even more.. “When you hear a joint crack spontaneously, it’s just a phenomenon of “cavitation”, that is to say that there is a gas bubble in the membrane surrounding the joint“, explains the specialist. In case of trauma, health professionals cannot manipulate a back without a report that authorizes the manipulation. During physiotherapy sessions or with an osteopath, massages can make your back “crack” in order to relax tense muscles and reduce pain.

Misconception 3: You have to wear ballet flats when you have back pain

FAKE. Too flat shoes like ballerinas (or flip flops) do not respect the physiological arch of the foot and the natural arch of the pelvis. “The back is a reflection of our posture : if you have bad shoes or if you wear uncomfortable shoes, you can adopt a bad gait and this can create lower back pain or tension in the shoulders or neck” explains our interlocutor. Likewise, “wearing heels that are too high increases the natural arch and can cause muscle contractures“, And above all, a deformity of the foot.
>> We prefer shoes with a small heel of 0.5 to 1 cm which are more physiological.

Misconception 4: We have back pain because we have injured ourselves

FAKE. “Back pain can come from overuse on a daily basis. It is not necessarily due to injuries, bad gestures, false movements or lesions such as a herniated disc, disc disease or osteoarthritis. The genetic capital also plays on the state of our back and our propensity to have low back pain.“, explains Dr. Queinnec. Persistent back pain should lead to consult the general practitioner who will do an interrogation and a clinical examination to establish a pre-diagnosis. If necessary, he will prescribe additional examinations (x-rays, MRI). Depending on the results, a rheumatological or surgical opinion may be considered.

Misconception 5: You have to sleep on a hard mattress

FAKE. “A rather firm mattress is preferable because the body will be less likely to sink into it. On the other hand, it should not be chosen too hard so as not to create tension during sleep. Many brands offer to test the mattress for several nights and return it if it is not suitable“, reminds Dr. Queinnec. The choice of a mattress is individual.
• The board : the shoulders, pelvis and entire spine should sink slightly into the mattress when you are on your back.
• The best position for sleeping: “Lying on your side curled up best maintains alignment of the pelvis and spine.“

Misconception 6: Having back surgery is inevitable sooner or later

FAKE. Surgery should be done case by case. “In the vast majority of cases (herniated disc, disc disease, etc.), back pain will pass medically, whether through rehabilitation with a physiotherapist or an osteopath, exercises to do at home, acupuncture , occupational therapy, sophrology… But sometimes, there are cases of failure and surgery is the last resort that can be offered to the patient, Despite everything, a rehabilitated or operated back pain can always recur“, explains the doctor. Alternative medicine is effective in case of back pain, particularly acupuncture, and can accompany rehabilitation.

Misconception 7: Stress is a cause of back pain

FAKE. “Stress is not a cause of back pain but an aggravating factor. For what ? Because we are simply more contracted, stiffer, less flexible and less adaptive. Thus, when we are more stressed, we have more easily lumbago, contractures or muscle elongation and we are more likely to get injured.“explains Dr. Queinnec. If it is mismanaged or excessive, stress can increase the painful sensation and prolong it.

Misconception 8: Cold relieves pain

FAKE. Put cold, like an ice pack “relieves bruises, hematomas and more generally on traumatic pain due to a fall or shock: the cold helps to reabsorb the hematoma and anesthetize the pain“, explains Dr. Steffen Queinnec. On the other hand, a hot bath or a hot water bottle relaxes and relaxes the muscles : “Heat relieves more chronic muscle pain such as muscle contractures or lumbago.“

Misconception 9: Gaining weight has little impact on the back

FAKE. “THE being overweight promotes back pain. In a static position (standing or sitting too long), the weight that is carried on the vertebrae – especially on the lower lumbar vertebrae – is almost multiplied by three. That is to say, when you have ten extra pounds, you inflict pressure on your back which is 30 kg higher.“, specifies the orthopedic surgeon. Lower back pain, osteoarthritis, lumbar disc degeneration are more common. Please note that significant weight loss is often associated with significant muscle and/or postural loss: it must therefore be accompanied by rehabilitation and sports care.

Misconception 10: Sport is forbidden in case of back pain

FAKE. The worst mistake is to stay immobilized, lying down and waiting for it to pass. The risk : tense up more and hurt yourself as soon as your back is strained. “You must try to be in motion, stretch, walk and gradually resume sports exercises fairly gentle, in intervals (2 or 3 sessions of 15-20 minutes per week). In addition, prefer symmetrical sports and those that do not require twisting of the back“, advises Dr. Queinnec.

• The best sports for back pain: cycling (with a well-adjusted bike), swimming (front crawl or back crawl), Pilates when you have acquired good sheathing.
• The worst sports for back pain: squash, badminton, tennis, combat sports like boxing or judo, impact sports like running.

Thanks to Dr. Steffen Queinnec, orthopedic surgeon and traumatologist. Interviewed in October 2019.