People suffering from lower back pain often think a specific moment of extreme exertion triggered their sudden discomfort, even though simple daily tasks could just as easily have contributed to the ailment, an Australian study suggests.
When researchers asked 999 adults what caused their back problems, about two thirds blamed a specific experience on the day their pain surfaced.
Because triggers for lower back pain can occur days, or even weeks or months before the sudden onset of discomfort, it’s likely that many patients misplaced blame, said Dr Scott Forseen, a back pain researcher at Georgia Regents University in Augusta.
“While acute back pain tends to have a good prognosis and will improve over time, failure to recognize red flags can have significant negative consequences,” Forseen, who wasn’t involved in the study, said by email.
Worldwide, lower back pain is a leading cause of disability, afflicting about one in 10 people, according to a recent estimate. The odds of developing this type of pain increase with age. It can often be treated with medication, exercise, heat or ice application, or sometimes with surgery.
An understanding of what really may have triggered an episode of back pain may help people avoid those causes in the future, according to the study authors, who were led by Patricia Parreira at the University of Sydney.
The researchers analyzed data from surveys completed by patients who went to their doctor seeking treatment. On an average, study participants were 45 years old and overweight, and 59 percent were male.
The study team looked at how often the patients named common, established back pain triggers, as well as less well-known triggers, and used the information to see how often patients under or overestimated the harmful effects of certain triggers.
Among the common triggers for lower back pain researchers asked about were lifting heavy or hard to grasp loads, vigorous exercise, sex, fatigue or drinking alcohol. Participants also specified whether exposure to the trigger was immediately before the pain started, or within the previous 24 hours.
Typically, the participants had around six previous episodes of lower back pain. Patients said the current flare-up generally lasted about five days, including more than two days of reduced activity due to pain.
Many participants reported experiencing one of the common causes of back pain on the day the flare-up started. But, only 17 percent of them recalled experiencing these triggers during the previous 24 hours.
“Common sense tells us that lifting heavy loads, awkward posture, vigorous activity and slips/trips/falls could cause back pain,” Forseen said. “These scenarios are commonly encountered in everyday experience, making it easier to tie the two together as cause and effect.”
It’s not surprising that the origins of pain that patients failed to acknowledge in the survey included alcohol consumption, sex, distraction and fatigue, he said.
“Answering in the affirmative on these items may be too embarrassing, may not make common sense, or may require the person to acknowledge some type of fault of their own,” Forseen said. “When we answer survey questions, we tend to answer in a manner that will be viewed favorably by others.”
One limitation of the study is its reliance on human recall, the authors acknowledge in the journal Pain.