Back pain is one of the biggest reasons we seek medical care and low back pain is listed as a leading cause of disability worldwide. But there’s a lot of misinformation out there and along with it a lot of bad treatments.

So today I want to bring up five things you should know about back pain.

Number one: back pain isn’t just limited to the spin our back is made of bones called vertebrae that run from your neck to your tailbone. These vertebrae form the spinal column which houses the spinal cord. Each vertebrae is also connected to the others by ligaments. Between each vertebrae are discs that provide cushion and help absorb and distribute pressure. Within the structure of connections also joints muscles tendons and nerves. Our back isn’t held up by just the spine. In fact, a lot of that work is done by our core which includes our abdominal muscles low back muscles hips and glutes, and pelvic floor. The muscles in our core take pressure from the rest of the spine. Every day we put all kinds of pressure on our backs when we walk 10 carry out groceries leave boxes and even when we sit. So it’s not only spinal pressure but torn muscles or sleep teeth that could be contributing to back pain. The pain itself is even more complex. Often it has pain signals are processed in the nerves or in the brain that perpetuates the pain. Other factors like Stress and Anxiety can amplify pain. These complexities while treating back pain can be so frustrating and white enticing to seek out all sorts of medically suspect care.

Number two: chiropractic treatment is not backed by science. Going to chiropractors for spinal manipulation is very popular, especially in the United States. But the statics that looked at 45 systematic reviews found no evidence supporting Chiropractic treatment as effective for any medical condition. I’m not denying that people who visit chiropractors sometimes feel better after a session but studies suggest that the comfort and relief from being touched is most likely a placebo effect. This is also a reminder that chiropractic treatment can sometimes be dangerous. There are people who have suffered vascular Strokes after neck adjustments.

Number three: Imaging techniques like MRI or x-ray don’t always help with diagnosing back pain for instance you can be in a lot of pain and get an emery showing a pristine spin with nothing out of the ordinary. Or you could have no pain whatsoever and an MRI could turn up abnormalities like a bulging disc. What’s more sometimes when you do have pain and an abnormally key on MRI may have nothing to do with it. Additionally, an MRI doesn’t always capture what’s happening with your muscles or tell us how pain is being processed in the brain. There are instances when Imaging helps to rule out a serious problem, especially after trauma or an accident or if there are red flags meaning warning signs for cancer or troubling neurological symptoms. Bed for the majority of people with back pain imaging has actually been associated with worse patient outcomes and unnecessary surgeries.

Number four: back surgery can sometimes do more harm than good. Researchers analyzed studies on two types of spine surgery Lumber spine fusion and lumber spine decompression. They found that neither of the surgeries was more effective than no surgical treatment which I’ll get into in a bit.

Number five: physical therapy is a really good option for back pain. A well-designed Physical Therapy Program can often be very effective at treating acute and chronic back pain. But it does take work good Physical Therapy involves not just assessments but also a structured home exercise program which you need to do regularly. There are also multidisciplinary clinics that can offer multimodal therapy like medications physical therapy and sometimes injections.

What I’m saying is the reason is always an easy fix for back pain. The solution takes time and sometimes needs a multi-pronged approach. For now, you can show your back some low by staying active and doing exercises that strengthen your muscles including your core.