Back pain affects many people, and persistent myths can cloud decisions about care. Meghan Murphy, M.D., a neurosurgeon with Mayo Clinic Health System, reviews eight common misconceptions about back pain and offers evidence-based guidance that emphasizes lifestyle factors, movement and conservative treatment options.
Back pain is widespread, and misconceptions about its causes and treatments remain common. Meghan Murphy, M.D., a neurosurgeon with Mayo Clinic Health System and contributor to Mayo Clinic’s back pain myth guidance, discusses eight frequently held myths and the facts behind them.
Myth: Lifting heavy objects is the main cause of back pain.
Lifting heavy objects with poor form can contribute to back pain, but according to Mayo Clinic materials, the major drivers are a sedentary lifestyle, poor posture, obesity and genetic factors. Everyday habits and overall conditioning generally play a larger role than an isolated lifting incident.
Myth: Bed rest will make back pain better.
Mayo Clinic notes that this depends on the cause of pain. If it is due to a muscle strain, taking it easy for a short period may help. However, prolonged bed rest can make back pain last longer or worsen, especially when pain is related to nerve compression, a disc problem or joint degeneration. In those situations, clinicians typically recommend modifying activities, choosing low-impact exercise such as walking or swimming, and avoiding repeated bending, twisting or heavy lifting, rather than extended inactivity.
Myth: Back pain is caused by sitting on a fat wallet.
Mayo Clinic guidance explains that sitting with a large wallet in a back pocket can tilt the pelvis and compress the sciatic nerve, which runs from the lower back through the hips and buttocks and down each leg. This often leads to leg or hip pain, numbness, or pins-and-needles sensations after prolonged sitting or driving, rather than being a primary cause of back pain. Removing the wallet and, when appropriate, using over-the-counter anti-inflammatory medication may ease symptoms. Ongoing leg pain or numbness should be evaluated by a health professional.
Myth: All back pain signals a serious underlying condition.
According to Mayo Clinic’s Q&A on back pain myths, most back pain is caused by muscle strains or sprains, not by serious problems involving the discs or vertebrae. In many cases, symptoms improve on their own over time with conservative care such as activity modification, simple pain relief measures and gradual return to normal movement.
Myth: Exercise should be avoided when you have back pain.
Mayo Clinic specialists generally recommend exercise and physical activity to help manage and prevent many types of back pain. Strengthening core muscles, including the back and abdominal muscles, improving flexibility, and maintaining a healthy weight can support a healthier spine. People are advised to adjust the type and intensity of exercise to what they can tolerate and to seek medical advice if pain does not improve or progressively worsens.
Myth: Surgery is the only solution for chronic back pain.
Mayo Clinic emphasizes that many causes of chronic back pain are not resolved by surgery. Non-surgical treatments — including physical therapy, medications, injections and lifestyle changes — are often effective in reducing pain and improving function. Surgery may be considered when certain warning signs are present, such as pain that intensifies at night or when lying down, pain that spreads down one or both legs, weakness, numbness or tingling in the legs, or new problems with bowel or bladder control. These symptoms warrant prompt medical evaluation.
Myth: A firm mattress is always best for back pain.
Evidence summarized by Mayo Clinic indicates there is no single ideal mattress type for everyone with back pain. Some people feel better with a firm mattress, while others prefer medium or softer options. The key is to choose a mattress that offers adequate support and comfort based on individual body type, sleep position and personal preference.
Myth: Poor posture does not contribute to back pain.
Mayo Clinic materials point out that spending long periods slouched over a computer or looking down at a phone can strain muscles and joints over time. These habits can contribute to pain in the back, neck and shoulders. Practicing good posture, taking regular breaks from screens and using ergonomic equipment can help prevent or lessen these problems.
For long-term back health, Mayo Clinic recommends strategies such as maintaining a healthy body weight to reduce stress on the spine and other joints, strengthening core muscles so they can better support the back, and staying regularly active. Some back problems are linked to factors that cannot be changed, including prior injuries, arthritis and genetics, but consistent self-care and conservative measures can still play a significant role in managing symptoms and supporting function.
