Bad Back Day

What the day is

Bad Back Day is observed on January 13. Low back pain is the leading cause of years lived with disability worldwide, and most people will have an episode at some point.

Origin and background

The origin of the observance is not documented. What has changed is the advice, and the reversal is worth knowing because the old version is still repeated constantly.

Bed rest was the standard prescription for decades. Trials found it makes outcomes worse: people told to rest recovered more slowly than those who stayed as active as their pain allowed. Staying moving, including returning to work in some capacity, is now the mainstream recommendation for ordinary back pain.

Scans have been similarly rethought. Imaging of people with no pain at all finds disc bulges, degeneration and other alarming-sounding features in a large share of them, rising steadily with age. These are, in a sense, wrinkles. Because such findings are so common in symptomless people, an early scan often turns up something incidental, which then gets blamed for the pain, worries the patient and can lead toward treatment they did not need. Guidelines now advise against routine imaging for uncomplicated back pain in the first weeks.

Posture has also been demoted. The evidence linking any particular sitting posture to back pain is weak, and the better summary is that the problematic thing is holding one position for hours, whichever position it is.

Some symptoms do need prompt attention rather than patience: significant leg weakness, numbness around the groin, loss of bladder or bowel control, unexplained weight loss, fever, or pain following a serious fall. Those warrant medical assessment rather than waiting it out.

How to take part

• Keep moving within what the pain allows, rather than going to bed.
• Change position often. Duration matters more than posture.
• Do not push for an early scan for ordinary back pain.
• Build general strength and walking rather than hunting for one corrective exercise.
• Get the warning symptoms above checked promptly, since those are the exceptions.