Common Beliefs About Back Pain, Core Stability, Posture and Bending

Ben cites Ben Darlow's survey of beliefs in New Zealand: 69% thought they should take it easy, 59% would avoid activities that cause pain, 55% thought the risks of exercise outweigh the benefits and 35% saw bed rest as the main therapy. These beliefs work against the advice to stay active. The evidence does not show that people with back pain are weak, and they can improve after exercise without any change in the strength or mobility the program targeted. A systematic review of 29 studies found stabilization exercises no better than other active exercise long term. Studies including work by Hodges show people with back pain often have more trunk muscle co-activation and stiffness, not less. Lumbar lordosis, pelvic tilt, leg length and muscle length showed no clear link with back pain, and anterior pelvic tilt is common in men without pain. In Danish manual workers, more time bending forward around 30 degrees was linked to lower pain. Activity shows a U-shaped relationship with back pain, and perceived stiffness did not match measured stiffness.