In the world of social media, we are bombarded with health information and flashy captions claiming “the 1 tip to fix”, or the “10 things to avoid” and most of this we quite rightly ignore as spam. The problem comes when this information is perpetuated by credible sources and “Instagram experts” which is something that I see more and more on my feed coming from people who should know better.
Although it is done with good intention, there is no real thought for the negative impacts the words we use can have on us. This phenomenon is known as Nocebo which is basically placebos' evil twin. The words and phrases we use can harm people making them feel more pain and worry about normal activities which are not causing a problem. Posture is a great example of this, although certain positions may temporarily aggravate pain, no one posture is better than any other nor has posture been shown to predict future pain!
Text neck is an example of this, we are scared to bend and look down for fear of irritating our necks; this worry may actually lead to pain and a problem that never even existed! We have been doing these kinds of activities forever... would we be as worried about a child reading or playing scrabble?
We know that exercise is great for helping back pain and that no type of exercise has been shown to cause pain, yet I regularly see people who have been told to stop and activity that they enjoy for fear of “putting their back out” this is completely untrue and may long term actually cause more harm than good.
Our spines are very strong and robust, we can tolerate loads of positions very well. In fact, how we feel about the activity we are doing probably has more impact than the actual posture. The takeaway from this is to move more. Any position held for a long time may become uncomfortable so “the best posture is the next posture”; we are not a tower of blocks neatly stacked - we are very complicated and resilient. So, trust in your spine, relax and enjoy life; regardless of what social media tells you.
This mini blog was written by Andrew MacMIllan MOst, PGCME. Andrew is the unit leader for exercise rehabilitation at the London school of osteopathy and lectures nationally to allied health professionals on a variety of topics, he is available at the Penn clinic Tuesdays and Fridays.
Sources: Darlow B, Dean S, Perry M, Mathieson F, Baxter GD, Dowell A. Easy to harm, hard to heal: patient views about the back. Spine. 2015 Jun 1;40(11):842-50. Darlow B, Dowell A, Baxter GD, Mathieson F, Perry M, Dean S. The enduring impact of what clinicians say to people with low back pain. The Annals of Family Medicine. 2013 Nov 1;11(6):527-34. Testa M, Rossettini G. Enhance placebo, avoid nocebo: How contextual factors affect physiotherapy outcomes. Manual therapy. 2016 Aug 1;24:65-74. O'Sullivan K, O'Dea P, Dankaerts W, O’Sullivan P, Clifford A, O’Sullivan L. Neutral lumbar spine sitting posture in pain-free subjects. Manual Therapy. 2010 Dec 1;15(6):557-61. Suri P, Rainville J, de Schepper E, Martha J, Hartigan C, Hunter DJ. Do Physical Activities Trigger Flare-ups During an Acute Low Back Pain Episode?. Spine. 2018 Mar 15;43(6):427-33.