Back pain can seem to come out of nowhere and have a big impact on your family, hobbies, social life, and career. Being an informed patient can have a big effect on your outcomes. With that in mind, I've compiled some little known insights into back pain that should be helpful as you navigate treatment:

  1. Your Level of Pain does not Equal Injury/Damage
    People experience pain differently. An acute injury that causes excruciating pain to one person may cause little or no pain to another.

    For example, as Dr. Ullrich points out in his article on back pain, a patient with a simple muscle injury may end up in the emergency room with excruciating pain, while a patient with a degenerative disc may experience only mild, intermittent discomfort.

    Chronic back pain (pain lasting for 6 weeks or longer) is even more mysterious. Sometimes chronic pain persists even after the injury is healed.

    Read more about acute and chronic pain

  2. Imaging Tests do not Equal a Diagnosis
    This one is counter-intuitive, but it's important to keep in mind.

    A degenerative disc or other abnormality that is seen on an imaging test (MRI, CT scan) is not necessarily a cause of your back pain. In fact, the vast majority of people who never have had an episode of back pain will have a degenerated or herniated disc on an imaging test.

  3. Disc Degeneration is Natural

    Degenerative Disc Disease
    Disc degeneration is a natural part of the aging process. With age, all people will exhibit changes in their discs consistent with degeneration. However, not all people will develop painful symptoms. While the disc degeneration is likely to get worse with age, the associated pain usually does not get worse and in fact usually gets better over time. (See illustration of degenerative disc disease to the right)

    See How a Disc Becomes Painful

  4. MRI Scans are not Always Necessary
    So if disc degeneration is natural and imaging test results do not necessarily equal a diagnosis, is an MRI scan really necessary?

    No it's usually not. Most health professionals can develop a successful treatment approach based on a thorough medical history and physical examination.

    Only specific symptom patterns in a minority of cases indicate the need for MRI scans or other sophisticated tests. Typically, MRI scans are used when patients are not responding well to appropriate treatment.

    See Do I Need an MRI Scan?

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  1. Ice and/or Heat Applications Help
    Don't underestimate the impact of simply applying ice and/or heat to alleviate pain. Some visitors to our Facebook page claim they can't imagine life without their hot water bottles at night or the heat wraps they wear throughout the day.

    For more information, see Benefits of Heat Therapy for Lower Back Pain.

  2. Engage in Activity and Exercise
    Countless people in our forums and on our social media sites can attest to the fact that the right exercises or stretches can make a world of difference for their back pain.

    It's true, following an episode of back pain the last thing you may want to do is get up and move around. But this is often the best thing that you can do for your back pain.

    The two main reasons bed rest may be recommended are to reduce pressure on the discs in the spine and to stop the mechanical stresses that are irritating pain receptors. However, in most instances, more than 1 or 2 days of rest can be detrimental to recovery, potentially leading to adverse results, including muscle atrophy which in turn causes more pain.

    See Exercise and Fitness to Help Your Back

  3. The Spine Benefits from Anything that Enhances your Overall Health
    Simply following a healthy lifestyle can greatly enhance your spine health. Quitting smoking helps the back heal and stay healthy. A regular vigorous walking or other aerobic exercise program is essential and should be done at least three times a week. Daily hamstring stretching helps relieve undo pressure/stress to the lower back. Proper nutrition and stress relief can also help keep the back healthy.

    See Food for Thought: Diet and Nutrition for a Healthy Back

  4. Your Brain can Reduce Your Pain
    I am NOT saying the pain is all in your head, but it is important to realize that there are mental exercises you can do that have been clinically shown to reduce chronic pain.

    Read more about that study.

    Pain is not merely a sensation, like vision or touch, but the perception of back pain is actually strongly influenced by the ways in which your brain processes the pain signals.

    And you have some degree of influence over this. For example, skills can be developed to use your mind to achieve deep muscle relaxation, which in turn can help alleviate the associated pain.

    Please see Chronic Pain Coping Techniques - Pain Management and Chronic Pain As a Disease: Why Does It Still Hurt?