Back pain is an enormous problem that impacts upon individuals and society. Most people will experience back pain at some point in their lifetime and a proportion will suffer continuing and recurring problems. Those who do continue to experience pain require effective treatment and strategies so that the impact and the distress that it can cause are diminished. Our understanding of pain science has moved forward significantly, meaning that there are contemporary therapies that target changes that we know occur in the brain and other body systems. For example, the graded motor imagery programme and cognitive techniques that impact upon pain threshold and movement.
The early management of a back pain as with other acute pains, will often determine the outcome. Full understanding of what has happened, why it hurts, what is normal about the pain response, how to cope effectively and the use of appropriate medication are all important at this point–see your GP or consultant for advice on medication.
In persisting or complex cases, the assessment and treatment must be based upon the biopsychosocial model, considering the pain mechanism, influencing factors, beliefs & expectations, prior experiences of pain, the social impact (e.g./ work, family, sports) and fears in relation to movement and activity to name but a few. Pain is an output from the brain 100% of the time in response to an actual or perceived threat. Pain is always a normal response to the information that the brain receives from the spinal cord. In chronic conditions however, the way in which the nervous system changes means that danger signals can continue to be sent to the brain even when there is no actual threat. The brain must still respond by protecting the body by making the area hurt. The brain becomes very good at this, the analogy often used being an orchestra that learns to play one tune only. The pain tune–see Painful Yarns. To change the experience of pain in these cases requires a contemporary approach that is both ‘bottom up’ and ‘top down’. Bottom up refers to therapy that targets tissue health and movement, and top down pertains to training the brain and beliefs that are limiting recovery–see here for more details.
The BackCare Charity
BackCare is a national charity that aims to reduce the impact of back pain on society by providing information, support, promoting good practice and funding research. BackCare acts as a hub between patients, (healthcare) professionals, employers, policy makers, researchers and all others with an interest in back pain.
The BackCare App – Listed in The Sunday Times App List
If you are a back pain sufferer or you have a professional interest, you can join BackCare here