Based on the latest evidence – Prof Peter O’Sullivan outlines the myths and facts about back and neck pain and demonstrates practical and effective ways to self-manage it. Spinal pain is one of the most disabling health care disorders and commonly reported in dentists, with 50% reporting neck pain and 30% back pain. Historically spinal pain has been thought to be caused by damage or degeneration of the spine, weakness of the core muscles and or ‘poor’ posture. However, there is little strong evidence to support these beliefs. In contrast, there is growing evidence that spinal pain is complex and is influenced by a combination of factors such as genetics, gender, poor sleep patterns, inactivity, stress, muscle tension, fatigue and low mood. Persistent and disabling spinal pain is associated with complex processes where the body becomes overprotective and the nervous system over-sensitive. Cognitive Functional Therapy is a personalised, evidence-based approach that educates people about their pain, combined with pain control strategies to effectively manage it. Peter’s teams groundbreaking research in The Lancet showed this approach is more effective than usual care in reducing pain and activity limitation in people with chronic low back pain.