Low back pain (LBP) is one of the costliest and most disabling conditions affecting older adults. Not only can pain and disability interfere with the ability to carry out activities of daily living, but proprioceptive deficits associated with low back pain can impair balance, increasing the risk of serious falls and injuries that can dramatically affect long-term health and independence. Despite clinical guidelines on effective management of low back pain in the senior population, these ten prominent myths persist and continue to hinder recovery:

• MYTH: Back pain is inevitable with aging. FACT: Back pain is common but not inevitable. Prevalence increases with age and then levels off after approximately age 60.
• MYTH: Back pain usually indicates serious disease in older adults. FACT: Serious underlying conditions account for fewer than 5% of cases. Most low back pain is classified as “non-specific” and is not associated with serious pathology.
• MYTH: Imaging is necessary in adults over age 50 with low back pain. FACT: Imaging in the absence of “red flags” (such as cancer, fracture, infection, or cauda equina syndrome) can lead to unnecessary interventions and can cause more harm than benefit.
• MYTH: Pain should guide behavior—avoid lifting, twisting, and bending when experiencing low back pain. FACT: Physical activity promotes recovery, while prolonged avoidance and inactivity are associated with worse outcomes. Pain during activity does not usually indicate tissue damage.
• MYTH: Bed rest is recommended for low back pain in older adults. FACT: Bed rest can cause more harm than good, particularly when prolonged, and may contribute to deconditioning and delayed recovery.
• MYTH: Medication should be the first-line treatment for low back pain. FACT: Clinical guidelines support nonpharmacological treatments as first-line approaches, including manual therapies such as those provided by chiropractors.
• MYTH: Surgery is effective for primary back-dominant low back pain. FACT: Surgery is not recommended for primary back-dominant pain and may result in worse outcomes or unnecessary complications.
• MYTH: Chronic low back pain in older adults is always caused by structural damage. FACT: Structural changes seen on imaging correlate poorly with pain severity or disability. Psychosocial factors play a substantial role in persistent pain.
• MYTH: Injections, ablation, and nerve blocks are highly effective treatments. FACT: For nonspecific low back pain, these interventions often provide no greater benefit than sham treatments and are associated with increased adverse events in older adults.
• MYTH: Disk herniations commonly cause leg pain in older adults. FACT: Disk herniations are less common in this population; clinical findings are often more reliable than imaging alone.

Unfortunately, this misinformation is frequently reinforced by family members, friends, social media, pharmaceutical companies, other industries, and even healthcare providers. These myths about back pain foster inaccurate attitudes, beliefs, and behaviors that can lead to inappropriate, costly, and sometimes harmful treatments. Additionally, such misconceptions can result in psychological consequences—including fear of movement, poor self-efficacy, low motivation, anxiety, stress, and depression—all of which contribute to greater disability and slower recovery. The good news is that, in most cases, chiropractic care serves as a conservative treatment option that can help reduce pain and disability, enabling older adults to more easily maintain independence and perform activities of daily living.