Myths about Treatment for Back Pain and Back Problems

Treatment for lower back pain is usually initiated without a specific diagnosis or medical consultation. For effective care and relief of symptoms, a treatment program that is coordinated by a health care professional is recommended.

Here are a few common myths about the treatments available for back pain and the accurate facts supporting the truth for each.

Myth: Chiropractic Adjustment Makes Back Pain Worse

Truth: When delivered by a trained, licensed, and experienced chiropractor, and when done for the appropriate diagnoses, chiropractic treatments for lower back pain can have pain-relieving and healing effects on the lumbar (lower back) tissues. Manual techniques used by chiropractors help achieve the following goals ¹ Lemmon R, Roseen EJ. Chronic Low Back Pain. In: Integrative Medicine. Elsevier; 2018:662-675.e3. ^{, 2} BATAVIA M. Spinal Manipulation. In: Contraindications in Physical Rehabilitation. Elsevier; 2006:298-323. :

• Reduce pain
• Improve soft tissue health
• Release tension within joints
• Improve joint movements

It is common to experience certain side effects after a chiropractic treatment, especially if high-velocity low-amplitude (HVLA) spinal manipulation is used. On average, over 50% of patients who undergo chiropractic adjustments may experience some degree of muscle stiffness, localized pain, and soreness. These side effects may be experienced as soon as within 4 hours of treatment and generally subside within 24 hours. ³ Bise CG, Piva SR, Erhard R. Manual Therapy. In: Orthopaedic Physical Therapy Secrets. Elsevier; 2017:85-94.

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Myth: Massage Worsens Back Pain

Truth: Complementary medicine for back pain includes therapeutic massage. Therapeutic massage is delivered by a licensed and trained professional through hands-on manipulation of the soft tissues of the body to ease muscular aches and pains.

In treating back pain, massage can offer symptomatic relief of pain through the following methods ⁴ Furlan AD, Giraldo M, Baskwill A, Irvin E, Imamura M. Massage for low-back pain. Cochrane Back and Neck Group, ed. Cochrane Database of Systematic Reviews. Published online September 1, 2015. :

• Improving physical and mental relaxation
• Increasing pain threshold through the release of natural pain-fighting hormones called endorphins

In general, massage is recognized as a safe therapeutic remedy. Depending on the type of massage administered, some degree of minor pain or discomfort may be experienced during or shortly after receiving the massage. These symptoms typically resolve within a few hours.

As with all types of treatments, there are specific contraindications for massage, such as applying pressure over an area with acute inflammation, skin infection, fracture, or other concerning problems. ⁴ Furlan AD, Giraldo M, Baskwill A, Irvin E, Imamura M. Massage for low-back pain. Cochrane Back and Neck Group, ed. Cochrane Database of Systematic Reviews. Published online September 1, 2015.

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Myth: Herniated Disc Won’t Heal Without Surgery

Truth: The searing pain from a lumbar herniated disc can cause significant discomfort depending on the extent of herniation and the type of nearby tissues that are affected, such as the sciatic nerve roots. For the vast majority of people, the pain usually resolves without any lasting pain or complications.

• Research indicates that over 85% of patients with acute herniated disc experience complete resolution of symptoms within 8 to 12 weeks. ⁵ Dydyk AM, Ngnitewe Massa R, Mesfin FB. Disc Herniation. [Updated 2020 Nov 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441822/
• For those who do not experience symptom resolution, nonsurgical treatments, including physical therapy, manual manipulation, oral medication, and injection treatments, may be tried. ⁵ Dydyk AM, Ngnitewe Massa R, Mesfin FB. Disc Herniation. [Updated 2020 Nov 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441822/
• Nonsurgical treatments are effective in controlling disc herniation-related pain and help reduce and eliminate pain. ⁵ Dydyk AM, Ngnitewe Massa R, Mesfin FB. Disc Herniation. [Updated 2020 Nov 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441822/

Surgery for a herniated disc is rarely necessary unless a medical emergency is present. Surgery may also be considered as the last resort when neurological symptoms do not improve or worsen. ⁵ Dydyk AM, Ngnitewe Massa R, Mesfin FB. Disc Herniation. [Updated 2020 Nov 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441822/

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Myth: Back Pain Is Constant and Always Gets Worse

Truth: Back pain affects almost everyone at some point during their lifetime, and most people recover within a few months. For those who develop chronic back pain (pain that lasts 3 months or longer), recurrences are possible, with periods of relief in between. ⁶ Freburger JK, Holmes GM, Agans RP, et al. The rising prevalence of chronic low back pain. Arch Intern Med. 2009;169(3):251-258. doi:10.1001/archinternmed.2008.543

If back pain is constant, adequately treating the underlying cause and making lifestyle modifications to rehabilitate the spinal structures can help provide longer-term pain relief. Over time, recurrences or flare-ups are possible, but seeking timely treatment can help decrease the severity of symptoms and the frequency of recurrences, and/or significantly reduce the pain over time.

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