Physiotherapists call for change of language on back pain

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What you need to know: 98 per cent of back pain cases are non-serious

Back pain can be extremely painful, debilitating, and even very scary. When people throw around language like ‘crumbling spines’ and ‘slipped discs, it can be too easy to fear the worst. However, the truth is that most back pain cases aren’t serious and will clear up in due course and there’s no need to keep off your feet for days on end.

Bending, lifting and other movements are widely believed to cause harm and this leads many to avoid doing them. Yet while it can be very painful and distressing, research shows that 98 per cent of back pain is not serious and it’s actually better for your back if you carry on with your daily activities, where possible.

The Chartered Society of Physiotherapy (CSP) has produced new materials aimed at reassuring the public and changing the tone of discussion around the condition, both in the media and among health professionals.

Chris Newton, a physiotherapist at University Hospitals of Leicester NHS Trust, who worked with the CSP to develop the new resources, said:

“We frequently see patients who avoid – or are very careful about - bending, lifting and other simple, everyday movements that they have come to believe will cause them harm.

“At the heart of this lies the understandable concern that because they are in a great deal of pain, something must be seriously wrong but we know that with 98 per cent of back pain that is not the case.

“Some misconceptions are spread in the media but it’s true that health professionals are also culpable of using language that causes patients to worry.

“This in turn can lead people to become fearful of using their backs and they avoid doing the very things that will help them get better.

“So it is vitally important to get across the message that lower backs are strong, resilient structures, that permanent damage and serious causes are rare and that by gradually resuming normal movements and activities, in most instances people do get better.

“We need to reset the whole conversation around back pain.”

The new resources set out how surgery is rarely needed for back pain as conservative measures, such as exercise, are shown to be just as effective.

Also rarely required are scans, which can actually do more harm than good if seeing perfectly normal changes to the spine as we age lead a person to restrict their movement or avoid certain activities.

And the resources, which comprise a patient leaflet, short animation and webpages, show how there is no strong evidence on the benefits of painkillers for back pain.

The physiotherapists involved in the project, from the UK and Ireland, encourage people to keep moving, stay in work where possible, resume normal activities and adopt a healthy lifestyle.

If a person is still in pain after 6-8 weeks they should see a physiotherapist or GP.

The resources, which are available at, also cover the two per cent of cases where a person should be checked out medically as soon as possible.


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