Health Essentials from Cleveland Clinic

Misinformation abounds about back problems. How many times have you heard that exercise can hurt your back? Or that if you consult a spine surgeon about pain, you’re sure to wind up in surgery?

Back pain is a problem that is fairly common — as are the myths on the subject. If you have back pain, it’s important to get the facts.

We talked with Marzena Buzanowska, MD, Cleveland Clinic Center for Spine Health, to dispel these myths.

Myth: Exercise can hurt your back.

Fact: With professional guidance under a licensed physical therapist, exercise can help your back by strengthening the muscles that support your spine. A strong, well-conditioned back can withstand more stress and stabilize the spine better. In some instances, a spine-certified physical therapist can find a few simple exercises that will help relieve the pressure from a bulged disc to help with healing, Dr. Buzanowska says.

Myth: Herniated discs need to be surgically repaired.

Fact: The intervertebral discs, located between the vertebral bodies of your spine, act to cushion the spine against stress. These discs may rupture, or herniate, if the outer layer of the disc weakens. The jelly-like center of the disc leaks, irritating the nearby nerves and causing back and leg pain. More than 90 percent of herniated discs get better on their own with short rest or with treatment, such as physical therapy, anti-inflammatory medications or spine injections, Dr. Buzanowska says.

Myth: If you go to a spine surgeon, it’s certain you’ll end up having surgery.

Fact: Not necessarily so. Many spine surgeons often find themselves trying to talk patients out of back surgery, Dr. Buzanowska says. While there are a few spine conditions that require surgery, the vast majority of back problems are resolved without surgery. Surgery may be appropriate for select people who have exhausted conservative options. It all depends on your unique medical condition.

Myth: If you have bulging discs, you have a major medical problem.

Fact: Bulging discs are a normal part of aging, Dr. Buzanowska says. Our discs are like car tires that gradually lose air and wear down. This is why we may become shorter as we age. However, unlike car tires, an aged disc does not have to be replaced. Also, this problem causes pain in only a fraction of patients.

Myth: Magnetic resonance imaging (MRI) scans always show the source of back pain.

Fact: MRI uses a magnetic field and radio waves to create detailed images of the organs and tissues within your body. These scans can demonstrate annular tears, herniated discs and nerve compression. MRI scans do not show weak muscles or many other disorders that contribute to back pain. As mentioned earlier, MRI also will show the normal, age-related wear and tear that may be misleading as to the source of back pain sometimes. This is why a thorough physical exam is the most important source of information about the causes of your back pain, Dr. Buzanowska says.

Myth: The best thing for a sore back is bed rest.

Fact: It seems counterintuitive, but the best thing for your back is gentle exercise, Dr. Buzanowska says. Walking, for example, gets you out of a sitting posture and into a more neutral, upright alignment. Gentle, easy stretching may help as well.  Licensed physical therapists can best supervise this endeavor and can tailor a personalized strengthening and stretching routine for patients.

Myth: Spinal fusion surgery, which permanently joins two or more bones in the spine, always requires additional surgery.

Fact: We’ve all heard of someone who has had a failed back surgery, Dr. Buzanowska says. Yet, the reality is that when skilled surgeons perform spinal fusion surgery for the right medical reasons, the procedure rarely needs to be repeated.

Myth: Pinched nerves cause severe back pain.

Fact: That can be true, but only sometimes. Usually, an irritated or compressed nerve in your spine causes pain in your leg and foot, Dr. Buzanowska says.