7 Mistakes to Avoid When Treating Back Pain
Dr. Wala Hafiz: Millions of people suffer from back pain annually, which affects the way they sit, stand, walk, and even sleep, according to The Telegraph. The consequences are not limited to mere discomfort, as billions are spent each year to treat these cases. The priority is often to try to relieve this pain by resorting to quick and diverse solutions, but some common treatments we turn to may be ineffective and, at times, may even worsen the condition.
Nell Medd, a physiotherapist and author of the book *How to Be Your Own Physiotherapist*, explains that most people experience back pain at some point, yet most of us do not know the optimal way to manage it. We usually resort to solutions we have heard may help, but we often return to square one after a day or two, even if they seem to provide temporary improvement.
Common Mistakes
Experts note that there are some common mistakes people make when treating back pain, and they have offered what should be done as effective alternative treatments, as follows:
1. Staying in bed until the pain subsides
Patients usually resort to the rule of rest when in pain, but the correct approach, as shown by research, is that maintaining activity can lead to better pain relief and a quicker return to usual activities. A review conducted by the World Federation of Neurosurgical Societies in 2024 concluded that prolonged bed rest may lead to joint stiffness, muscle atrophy, and loss of bone density.
Medd explains, “When you feel back pain, your nervous system activates a protective mechanism by tightening the muscles surrounding that area. The best way to convince it to stop doing so is to gently and repeatedly demonstrate to it that movement is safe.” She adds that walking for ten minutes twice a day is “an excellent and highly suitable start,” noting that “most people find they can increase their activity slightly by the end of the week.”
A prominent study led by Australian researchers and published in *The Lancet* revealed that walking three times a week had a profound effect on people who had suffered from lower back pain in the previous six months, reducing the risk of recurrence by nearly half.
2. Taking inappropriate painkillers
Paracetamol alone is not recommended for treating back pain, as evidence suggests it does not outperform a placebo in relieving acute lower back pain or improving movement, quality of life, and sleep. Dr. Leanne Wood, Associate Professor and researcher in spinal physiotherapy at the University of Exeter, indicates that anti-inflammatories, such as ibuprofen, are more beneficial, especially in the early stages, and combining them with paracetamol may provide slight additional short-term pain relief.
Anti-inflammatories should not be used for long periods without medical advice, due to the potential for causing gastrointestinal, kidney, heart, and blood vessel problems. Stronger opioid painkillers should only be used when anti-inflammatories are unsuitable or ineffective, given the high risk of addiction. In general, it is advisable to use the lowest effective dose for the shortest possible duration.
3. Using back supports or orthotic insoles
The idea of providing additional back support using a brace or belt may seem reassuring, but although these devices may offer some temporary relief for some people, experts generally advise against using them for extended periods.
Dr. Wood explains: “Braces and corsets tend to reduce muscle activity. In the short term, you may feel back improvement because they limit muscle spasms, but over the long term, you become dependent on them, and people often feel unsafe moving without wearing them.” This can alter muscle function, causing some muscles to become underactive while others become overactive. Dr. Wood advises patients to treat the brace as a temporary support and to have a plan to discontinue its use as soon as their muscles are capable of taking over. She also advises against using orthotic insoles for postural correction, stating, “The scientific evidence supporting the effectiveness of ready-made postural insoles is weak.”
4 – Relying on massage or manual therapy: A recent review encompassing 301 studies indicated that manual spinal therapy was one of only six non-surgical treatments, out of 56, that demonstrated notable efficacy in alleviating back pain. Although it may provide temporary relief, Med emphasizes the importance of identifying the underlying cause of the pain, as the dysfunction may lie in another area, such as hip joint stiffness, inward foot rotation, or restricted thoracic cage movement. Manual therapy aims to improve mobility and reduce pain by addressing the causative dysfunction, rather than focusing solely on the back.
5 – Relying on transcutaneous electrical nerve stimulation (TENS) devices: Some people praise the effectiveness of TENS devices in pain relief; these devices send mild electrical currents through the body. These signals are designed to travel along neural pathways to prevent pain signals from reaching the spinal cord and brain, and to stimulate the body to release endorphins, a natural pain-relieving substance. However, scientific evidence supporting their effectiveness is weak. A systematic review conducted by the World Health Organization concluded that these devices achieve only a slight and temporary reduction in pain levels.
6 – Fear of bending or exercising: Fear of worsening back pain may lead to avoiding movement, but research suggests this can negatively affect movement patterns and exacerbate the problem in the long term. A research review showed that individuals with the greatest fear of movement tend to move their spine within a limited range when bending. Dr. Wood stresses the importance of continuing daily activities as much as possible, as movement helps relieve muscle spasms, restore the back’s range of motion, and maintain joint health. If certain activities are difficult, they can be modified by bending slowly, reducing the weight carried, or breaking the task into smaller parts, provided the movement does not cause severe or sharp pain.
7 – Failing to strengthen the back after pain subsides: Once the initial wave of acute pain subsides, increasing muscular strength can make your back more robust and resilient. Physical therapist Dr. Ro Ham states, “Working on strengthening the core muscles, gluteal muscles, and muscles that support the spine will help you achieve full recovery and prevent the problem from recurring. She recommends practicing simple exercises.”
