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Back Pain Myths Closing Sale Everything must go



The 2024 Global Year will examine what is known about sex and gender differences in pain perception and modulation and address sex-and gender-related disparities in both the research and treatment of pain.

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Everyone knows all about low back pain. This is probably by virtue of the fact that most of us have or will experience it at some stage. Everyone is an expert, clinicians and patients alike and there are a whole host of accepted truths about back pain that we all cling on to. Ideas that replicate themselves successfully across populations have been called memes. Successful memes spread like wildfire and become deeply entrenched. But truth is not necessarily a requirement for the successful meme….

A good example of one of these is that prolonged sitting can cause back pain. For years we have believed that the load placed on the spine may damage intervertebral discs (and other structures) and be a cause of pain. The evidence for this appears not to stack up, and it would seem that even our ideas of an ideal sitting posture are not entirely realistic. But to really kick this particular meme into the bin of back pain myths comes a cracking systematic review published in the Spine journal by Darren Roffey and his colleagues from Ottawa. They found strong and consistent evidence of no association between occupational sitting and low back pain and reasonable evidence that there is no dose-response relationship between sitting at work and back pain. In a separate review they found pretty much the same thing for occupational walking and sitting.

So perhaps it is time to stop fussing about sitting posture in back pain or many of the other biomechanical obsessions that we tend to embrace. At a conference a hung-over colleague of mine once grumbled that the mountain of back pain research hasn’t got us very far. I think that’s not quite right; we have learned loads about what isn’t true and the great thing about deconstructing what we think we know is that it opens the doors to developing fresh models of back pain to test.

So I have a challenge for the Body in Mind readership: what back pain myths can you think of that are ripe for some critical attention? I think this discussion could be a lively affair!

Claus A, Hides J, Moseley GL, & Hodges P (2008). Sitting versus standing: does the intradiscal pressure cause disc degeneration or low back pain? Journal of electromyography and kinesiology, 18 (4), 550-8 PMID: 17346987

Claus AP, Hides JA, Moseley GL, & Hodges PW (2009). Is ‘ideal’ sitting posture real? Measurement of spinal curves in four sitting postures. Manual therapy, 14 (4), 404-8 PMID: 18793867

Roffey DM, Wai EK, Bishop P, Kwon BK, & Dagenais S (2010). Causal assessment of occupational sitting and low back pain: results of a systematic review. The spine journal , 10 (3), 252-61 PMID: 20097618

Roffey DM, Wai EK, Bishop P, Kwon BK, & Dagenais S (2010). Causal assessment of occupational standing or walking and low back pain: results of a systematic review. The spine journal , 10 (3), 262-72 PMID: 20207335

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