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A Pain in My ... Back

A real pain in the back… We’ve all heard that before. Whether it’s a totally agonizing pain that takes your breath away, or a niggly sharp or intermittent dull ache, pain can be outright frustrating and sometimes debilitating. Most adults in their life have experienced back pain, and if not you, then someone close to you most likely has. In fact, statistics show that 80% of people will experience back pain at some point in their lives.

There has been research that has shown that two people with the same diagnostic scans of their back can have totally different pain experiences. One person may have to take time off work, rely solely on medication and be bedridden, whilst the other may be completely pain-free and unaware of their clinically ‘damaged’ lower back.

In both of my professions I am at the forefront for advice and education on injury management and prevention. I see on a daily basis a range of different injuries (acute and chronic), as well as varying levels of body awareness, pain perception and tolerance, and belief systems surrounding pain. There is no doubt that pain is multi-factorial, and individual experiences vary. Regardless of where you may fall on the pain spectrum (or not at all), follow these handy tips for management and prevention of pain:

Mind over matter…in some cases anyway. Differing responses to pain can be in part due to individual psychological attitudes and outlooks surrounding pain. Now, I’m not talkin’ a bright purple sprained ankle that has grown three sizes. I’m making reference to the pain that is persistent, that extends beyond the ‘normal’ expected time frame for the specific injury to heal (usually no more than 2-6 weeks), more specifically the type that stays far beyond its welcome (more than three months). In these cases, pain is often not caused by structural damage (even if it initially may have been), rather caused by subtle changes to the nervous system.

The vicious pain cycle…I often draw my patients a circle which represents the chronic pain process, to help them better understand their experiences. In short, the pain makes us anxious which can increase muscle tension, cramping, aching, fatigue and depressive moods. This psychological distress can worsen the pain. Our response to this is to STOP. We stop moving, we over-brace and ‘protect’ our body by avoiding exercise, taking time off work, not lifting the kids, until we are no longer doing the things we enjoy on a daily basis. The less we do, the weaker we become, which in turn increases our pain levels. The cycle goes on and on…

Keep moving. The best way to jump out of this circle of hell is to dampen your nervous system. Start by slowly introducing light physical activity again, such as yoga or Pilates. Be sure to incorporate mindful deep breathing to stimulate the relaxation response. Stretch and strengthen the surrounding muscles with at home exercises and stretches such as cat curls, squats, bridging, clams, gentle knee rocks and child's pose (refer to trusty ol’ Google or YouTube if you are unsure of these).

Your thigh bones connected to your shin bone…We all know the song, but do we all know the underlying meaning? Our body is a complex system which each and every part influencing, and being influenced by another part. This song is particularly relevant for diagnosing and understanding your back pain, as well as pain in any other region of the body. If at any point in the chain there is a dysfunction, such as a weak muscle, loose or stiff joint, ‘knock knees’, flat feet or high arched feet, this can cause pain in an area that is seemingly unrelated. This is where tuning in to areas above and below the site of pain becomes very important. When one thing is out it can set off a ‘chain reaction’, and without early intervention it can be difficult to determine the driver or cause of the injury. So your back pain can actually stem from a problem in your shoulder, and your foot could be the driver of your ongoing knee pain.

Posture up! The more time you spend in a poor posture, the more likely your body begins to default to this position. Muscles begin to function inefficiently and then eventually, when they have all but given up…ouch. Hello, back pain!

Don’t get angry, get even. Nearly every major muscle in your body has a corresponding muscle group that carries out the opposite function. The easiest way to grasp this concept is to imagine bending and straightening your elbow, which requires the biceps and the triceps to perform the opposing action of each other. When one of these muscles becomes weak, the other has to kick into over drive and do much more work.

A common presentation of this in back pain is the imbalance that occurs due to a sedentary lifestyle or a period of prolonged rest. Our muscles at the front of our hips become very tight and shortened and our lower back and bottom muscles become weakened. You mean to say this pancake butt isn’t here for good? When we become weak in our lower back, we are more susceptible to injury and ongoing pain. Answer? Get moving.

Don’t DIY. Seek professional help. More often than not, self-appointed treatment options are just maskers of pain and don’t alleviate the true cause. Common mistakes are over-resting, over-bracing, ‘cracking’ stiff joints, pulsed stretching with bad technique, misusing and become over-dependent on braces/strapping/aids, self-massage and manipulation. Physiotherapists are the experts in management and treatment of muscular, joint, tendon and ligament pain.

Pain can be persistent and outright frustrating. Get ahead and do your body a favour by implementing these healthy habits and behaviours today!

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