Why Pain?

Low back pain is very common with more than three out of every four people getting it at some point in their lives. The most common cause for back pain is a muscle strain due to either repeated microtrauma(poor posture or lifting techniques over a long period of time)or an accident or injury that results in a strain. Very rarely does anything actually occur to the spine itself because of all of the protective tissues(muscles, ligaments, etc) surrounding it.

Pain occurs in the body when the tissues perceive that if you don't stop doing what you're doing will hurt yourself. So pain is actually your body's way of warning you to change things! Most of the time some modification to the way you are lifting or sitting at your desk and take the stress off the tissues and the pain goes away. Most people often get better on their own within six weeks. However, some people will develop chronic back pain.

Chronic back pain is defined as lasting more than three months. There are many factors that include the reduction and avoidance of movement because of the fear of re-hurting the back, perceiving the pain as worse than it it which can result in inappropriate thoughts, poor perception of what you body can do and how strong it really is, increased stress in life, and something called central sensitization.

Physical exercise and mindfulness can often result in reduction in these factors helping you avoid developing chronic back pain. Central Sensitization is explained very well in the below video and may help you understand and then address your own pain.

All pain is a response to what your brain judges as threatening. If problems exist in the body but your brain doesn’t perceive it as dangerous, it will not hurt.

However, if no problem exists in your body but your brain thinks it is in danger, you will experience pain.

Should I get pain medication?
A study in Denmark looking at 10,000 people found that overall opoid drug treatment(pain killers like codeine, tramadol etc) did not provide relief from pain, did not improve patients’ qualify of life, and did not improve their ability to function. In addition, problems came up from their use including: side effects to the medication, misuse or abuse of the drug, and the need for larger doses over time. Even overdose and death occurred. Also, by taking a narcotic drug, you may not learn what will help your body heal!

MOVE!  

If you know your pain will not damage your tissues, you can move.  Here are the basic principles that you can use as a guide about pacing:

1. Decide what you want to do.  Start by picking an activity that you particularly want to do more.  For example: reading, walking, ironing, working, not wearing a neck collar, playing with the children, sitting, sleeping, driving, etc.

2. Find your baseline.  A baseline is the amount of the activity you can do before a flare-up.  A flare-up is an increase in pain, often suddenly, that leaves you hurting for hours, sometimes days.  For example, if you know that walking 1 mile will cause you to flare-up, but walking a half of a mile does not cause an increase in pain, your baseline would be a half a mile.

3. Plan your progression. Be gentle on yourself.  Taking the example above, you could plan to walk slightly further each day for the next week.

4. Don’t flare-up, but don’t freak out if you do! Because the alarm system is so sensitive, it is very difficult to completely avoid flare-ups.  If you do flare-up, do not stress out!  Remember a flare-up is your nervous system trying to protect you.  When you flare-up, it is tempting to give-up & forget what you know about pain, and seek some radical but inappropriate quick-fix treatment.  Don’t give up – stick with it!

5. It’s a lifestyle thing! Make it part of your daily routine, pace yourself and be mindful of your body with all your activities.

If you stick with these principles you will gradually return to a normal life and overcome your pain.