Should we try to prevent back pain at all? With Kieran O'Sullivan

Back pain prevention is examined critically, with emphasis on what current evidence does and does not support. The main argument is that commonly promoted strategies such as manual handling training, lifting techniques, posture correction, and ergonomic adjustments have shown limited effectiveness in preventing back pain. In contrast, general exercise appears to offer some benefit, especially in reducing recurrence. A central theme is that back pain is extremely common and often a normal part of life rather than a sign of serious damage. The talk challenges fear-based messages that present the back as fragile and needing constant protection. Instead, it highlights the importance of broader influences such as physical activity, sleep, stress, mood, job satisfaction, and general health. Load and movement are presented as necessary for resilience, not simply risks to avoid. Gradual exposure to bending, lifting, and carrying is framed as more helpful than avoiding these activities altogether. Management should focus on supporting recovery, encouraging self-management, and avoiding unnecessary alarm, imaging, or invasive treatment. Brief comments also address McKenzie therapy, imaging, medication limits, and the possibility that similar principles apply to other musculoskeletal pain.