Category Archives: Chronic low back pain

21Sep/15

Andy Murray wins despite back pain

Andy Murray back pain, Back pain, chronic back pain, Chronic low back pain, Chronic pain, Chronic pain in sport, , , ,
karlnorling | https://flic.kr/p/d5cPyA

karlnorling
| https://flic.kr/p/d5cPyA

Andy Murray wins despite back pain, a classic example of how the meaning and situation flavours the lived experience. Simon Briggs of The Telegraph said: “Not many players are capable of winning three points in a Davis Cup semi-final, as Andy Murray did to put Great Britain into the trophy match against Belgium in late November. But to do so with a bad back – an issue that Murray revealed only once the combat had finished – was a different story again: a quite exceptional feat of courage and stamina”. Pain is not well related to the state of the body tissues (joints, discs etc) but instead the perception of threat detected by body systems that protect us: nervous system, immune system, autonomic nervous system, endocrine system, sensorimotor system — one only has to consider phantom limb pain to realise this fact. One of the biggest reasons why persisting pain is feared is the belief that the severity equates to more damage or something more serious. You may also consider that some cancers remain painless and this is certainly serious. Pain is a protective device that motivates thinking and action to reduce the threat and restore normal physiological activity (homeostasis); it is a need state lived by the whole person — with ‘back pain’, it is the person who is in pain, not their back.

In Murray’s case, he was quite capable of focusing on the game, his body allowing this due to the context and the significance. There are many stories of sportsmen and women sustaining injuries and only knowing when the game is finished. We also had the scenario a few years ago when Messi collided with the keeper and experienced such pain that he thought his career was over. It was a bruise and he played the next weekend. The pain was still severe at the time though, reflecting the situation and the need as deemed by his body systems that protect. It works both ways.

Between games Murray may well have felt some stiffness, but he was able to re-focus. A few simple movements to nudge fluids around, ease off the muscular tension that is initiated and executed by the brain sending signals down via the spinal cord, perhaps a few reflexive messages contributing alongside the immune and autonomic activity. Context remained king though, as it was wholly more important to put all his attention on what was required to win than to start worrying about his back. That could be dealt with later, and indeed this is what happened as Murray did what he knew he needed to do to be victorious. All those top down signals, cultivated and delivered from a neuroimmune system, which countered those danger signals coming from his back (not pain signals — there are no pain signals or pain centres) — top down signals generated from his beliefs, expectations, mastery of focus and attention, as he hit flow, that state of being utterly in the moment. That’s a wonderful place to be and not a room where pain can enter.

Now that the game has finished, familiar aches and pains will flood Murray’s consciousness. There maybe additional and new feelings that evoke new thoughts and a need for re-assessment for the next best steps. These steps will need to include consideration of how Murray’s neuroimmune system and other systems that protect have learned to react (priming or kindling), the possibility of sub-conscious and environmental cues, expectations and of course an assessment of tissue health and function. From thereon in, a comprehensive treatment, training and coachng programme can address movement, body sense, neuroimmune-sympathetic-sensorimotor interactions to name but a few. It is worth pointing out here that such a programme is not unique to elite sports people, but a modern approach to pain and injury that should be accessible to all.

Richmond is the co-founder of a pain awareness campaign called UP | Understand Pain. Together with Georgie, they are using music and song to deliver the right messages about pain, particularly chronic and persisting pain; which are:

  • Pain can and does change
  • You can overcome pain and lead a meaningful life when you really understand it and know what you can do

** Pain Coach Programme for chronic pain, complex pain, persistent pain — t. 07518 445493

 

20Jul/15

Gillian’s story | back pain and mindfulness

Back pain, chronic back pain, Chronic low back pain, Chronic pain, Mindfulness, Pain Coach, Pain Education, UP | Understand Pain campaign, , , , ,
vintage typewriter by philhearing | https://flic.kr/p/9pRzps

vintage typewriter by philhearing | https://flic.kr/p/9pRzps

Many thanks for Gillian’s story | back pain and mindfulness

MY PAIN STORY – GILLIAN WESTON

I am always a busy person; I play short mat bowls several times a week and have represented my County and England, I run a Junior session for bowls, I love to swim and I am a member of Horsham Rock Choir. I use a computer as the main part of my job of Practice Manager for a charity.

My problems began in 2010 when I slipped on some ice and inadvertently tried to break my fall with my left arm. I had restricted movement and upper arm nerve pain but after some physio my situation improved.

In Dec 2012 I developed pain in both arms after lifting a heavy object at work. I was referred for physio in Jan 2013 when I was diagnosed with tennis elbow in my right arm and shoulder impingement/tennis elbow in the left. After some exercises my right arm improved but I had further physio in the following months for my left arm. During this time the worst aspect was the nerve pain from my elbow to my hand – no painkillers relieved it, and I was in constant pain with or without movement, even scratching my face or lifting a kettle were agony!

In September 2013 when I was still in a lot of pain and had a further condition added – ulnar nerve entrapment – I was given 2 steroid injections. There was an improvement but of course the underlying problems were still there and in January 2014 there was a return of my intense pain. A further course of steroids followed, but the actual injection was excruciatingly painful and I was left with numbness in my ring finger. I was pain free until Nov 2014 when I moved a pot in the garden and experienced a twinge in my elbow, the problem was exacerbated when I used a simple screwdriver in Dec at work and I ended up in the worst pain I had had for some time.

By Jan 2015 I was at the end of my tether and rather than go the NHS route saw a physio who I knew privately. She felt that my neck was also the cause of my problem plus bad posture. Her approach was more holistic and she gave me some acupressure to try and calm me down from my very distressed state. She even suggested counselling as she was concerned about my mental health as a direct result. I was at various times loaned a TENS machine, given ultrasound and massaged. She helped me address by posture and gave discussed calming techniques. She discussed with me how my mental state was affecting my pain but I was sceptical about this at the time and more or less dismissed it. There was a degree of improvement in my condition over the following month thanks to the new physiotherapist but I was still struggling day to day.

During all these periods in and out of pain I have had to stop playing bowls and going swimming, use my right hand more – particularly with the mouse at work, been unable to sleep on my left side, been restricted doing the dance moves at choir, and not been able to do many day to day things that I used to take for granted.

In March 2015 I attended Heathrow Airport with Horsham Rock Choir where Georgie Standage my choir leader and Richmond Stace were hosting an event for UP. I took one of the flyers and did my research via the UP website. I found the videos very interesting – in particular the one explaining how “all pain comes from the brain” (Lorimer Moseley). I took particular interest too in the mindfulness videos. But I also found the written information really useful too. Over the following weeks I used mindfulness apps and also ‘talked’ myself out of pain. When I felt pain I closed my eyes and tried to focus on other parts of my body; if I hit my weakened elbow (as I do frequently!) I told myself that it was fine, it would hurt for a while and then I’d be OK. I used Mindfulness to keep me calm and I found that my nerve pain lessened in the weeks that followed.

By May I was able to resume my bowls for short periods to use my mouse at work left handed, do my Rock Choir moves without pain and return to swimming. Significantly I can sleep for periods on my left side without pain – which I haven’t done for a long time!

It is now July 2015 and I have been pain free for just over 3 months–other than the odd elbow bash! I do get the occasional twinge, and very interestingly if I am stressed about anything I get a bit of nerve pain in my arm! Looking back some of the worst pain ties in with significant stressful times in my life. I am still wary and careful about exacerbating things, but importantly I feel that “yes I do have pain sometimes, but pain doesn’t have me”. I am indebted to UP for giving me my life back, and I continue to use the techniques I have learnt – in particular the Mindfulness Breathing – to keep me calm and in control.

17Jun/15

Sticks and stones

Back pain, Chronic low back pain, Chronic pain, Pain, Pain Education, Uncategorized, ,

Sticks and stones by Coloured Pencil Magazine (2014)

The old saying goes, “sticks and stones will break my bones, but words can never harm me”, however this is not exactly true when it comes to messages that are used to explain pain. Of course you could argue that words only cause harm if we interpret them as harmful rather than what they are per se, just words. Easier said than done!

Earlier this week I saw the word ‘instability’ written in reference to low back pain. This is a word that has been used frequently as a means to justify the use of something to create ‘stability’ and hence solve back pain. It has not worked.

The reason it has not worked is because there is no instability, and more importantly because pain is not a structure. I emboldened those words.

Pain is a whole person, emerging in that whole person in respect of a perceived threat. That is not a structure or a pathology. It is the whole person’s response to that pathology or injury that manifests as pain (in a bodily location), involving a number of systems that have a role in protecting us: e.g./ the nervous system, autonomic nervous system, immune system, sensorimotor system.

An injury or a pathology is not the same as pain. We cannot equate them as they are poorly related. An injury is an injury, and pain is pain, the latter being one of a number of responses to the former.

Back to instability. What does it suggest to the recipient of the message, “You have instability, which is why you have back pain”? How will this affect their pain, bearing in mind this is a pretty threatening thought? How will it affect their movement?

If there is true instability from a serious injury or a pathology that has affected the vertebrae to a significant degree, this calls for urgent surgical care. We are not talking about this scenario though, rather the number one global health burden that is low back pain. This pain is not explained by instability. If anything, the use of this word creates dependence rather than a proactive approach to restoring normal, confident movement and living life with less or no pain.

Pain is the vehicle that brings most people to the clinic. We need to give meaning to the individual’s meaning about their pain that they have already created, bringing their thinking into alignment with what we really know about pain. We must convey the right messages from the start to reduce the risk of chronicity. I just want to add that we need to tackle pain in the broadest way from the beginning, incorporating all dimensions–physical, emotional and cognitive–but importantly, how these interact as the whole person with prior experience, beliefs, genetics, gender, co-morbidities etc. The step-wise approach of trying medication, then physio, then interventions, then psychology etc (not always in that order!) does not work. It does not work. The whole-person needs to be addressed from word go. The whole climate and culture of health-caring for pain must change. And this includes the words we use, in reference to my earlier point.

When we understand pain, the actions that we take change for the better. When it makes sense and we know that we are safe to move and live, it takes us in the right direction. Each person has their own lived experience of pain that has been cultivated through the development of all the protective systems that have been subject to prior demands, and learned how to react in certain situations. This makes some people more vulnerable to chronic pain. Let’s help these people by asking the right questions at the start so that we can change the course that they are heading on.

We can and must do better. The science is there to be used and the thinking is there to be used. With the blending of neuroscience and philosophical thought, we are now in a time of great optimism. We can make lasting change for our generation and the next as we change our thinking and take big action across society and the globe, together.

********

Richmond Stace: Specialist Pain Physiotherapist

My overarching aim is to change the way that society thinks about pain so that we can tackle what is the number one global health burden, chronic pain. One to one with individual sufferers, via writing and talking, and the UP | Understand Pain campaign, I hope to shift thinking so that we can reduce the suffering that people feel across the globe.

11Jun/15

Stiff low back. Why?

Back pain, chronic back pain, Chronic low back pain, Uncategorized, , ,

Have you got a stiff low back? Stiffness is often part of the picture of low back pain. Why is this?

Stiffness is a conscious experience–a feeling that we sense, interpret and then label as ‘stiff’, usually describing difficulty moving a body part. And just like any other conscious experience, there are the embodied dimensions as well as cognitive and emotional elements: how does it feel? What does it mean for me? Hence to think about stiffness is to think about the body-body systems that create the feeling and meaning.

Stiff low back: there are three common types of stiffness that are addressed in different ways.

  1. Stiffness from actual shortening of the muscles and their compounding tissues
  2. Stiffness from muscles being told to be ‘on’
  3. Stiffness from changes at the joint

Stiffness from actual shortening occurs due to sustained positions or repeated positions being held so that the tissues change in their length. In so doing, there is less freedom of movement at the joints. This tends to gradually worsen as time progresses, with less and less movement at the joint causing further shortening. Regular movement, nudging into the limitation is key in overcoming this aspect of stiffness along with manual treatment that gives you the experience of movement into that part of the range. The manual treatment must sit alongside your understanding of what is happening and why this therapy is being applied, otherwise ‘top-down’ influences can interfere with success (see next section).

Stiffness from muscles instructed to be ‘on’ by the brain is part of the way that the body protects. Otherwise called guarding, the body-brain’s continual planning, expectation, anticipation and desire are embodied, responding to the environment and the context of the situation at that moment. Within our consciousness, different experiences seemingly appear and then fade away as others emerge. Stiffness and pain are no different in this respect, however they may emerge repeatedly in response to normal situations that pose no actual threat. But, due to the sensitive state and vigilance to the environment, non- or low threat stimuli are now interpreted as potentially dangerous and therefore the body responds. The first we know about this is the pain or tightening — the stiff low back. The pain and stiffness are motivators for us to take action, both in thought and behaviour. These thoughts and behaviours seek to reduce the threat and therefore reduce the pain (pain emerges in the person as a result of a perceived threat) and how the body is responding with it’s natural armour, the muscular system. As the need for defence diminishes, so the muscle tension eases and movement improves.

What reduces the threat and muscle tension?

  • Relaxation–this is a skill to learn
  • Mindfulness
  • Understanding pain and knowing that you are ‘safe’
  • Motor imagery

Changes at the joints can, but not always, affect the quality of movement. It is not a given that if your joints show arthritic change, movement will be problematic. Many people have arthritis but suffer no pain or stiffness. Whether you feel pain and stiffness or not is determined by many inter-related factors: e.g./ genetics, gender, past experience, beliefs, expectations, the environment; also known as pain vulnerabilities that all have an underpinning neurobiology that is becoming increasingly understood.

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09Jun/15

Do you have persisting low back pain?

Back pain, chronic back pain, Chronic low back pain, Chronic pain, , ,

Persisting low back pain is common. It is the number one global health burden (Vos et al. 2012) and hence is the cause of much suffering,  and personal and societal cost. We need a re-think, because the misunderstanding of pain is at the root of this vast problem, especially when it comes to chronic low back pain: persisting or recurring.

I see people every day with chronic low back pain. It is one of the main vehicles that brings patients to my clinic. In many cases, chronic low back pain is part of the presentation with other complaints and problems including widespread pain, anxiety, irritable bowel syndrome, headaches, migraines, pelvic pain, disturbed sleep, poor concentration and performance at work, relationship disharmony and fertility issues. Is there a connection between these seemingly disparate issues? Yes. And by focusing on the whole-person, as suggested by the latest thinking in pain neuroscience, neuroscience and philosophy, we can create a tangible way forward.

So what can we think about? Here are some ideas with examples:

1. What is pain all about in this person?

  • Protection

2. How is the persisting back pain emerging in the individual?

  • Where in the body is the protection emerging?
  • Which (protective) body systems are interacting?
  • What is the context for the pain?
  • What features of the individual’s narrative suggest a vulnerability to persisting pain?
  • What habits of thought and action (the two being utterly entwined) exist?

3. What are the person’s beliefs about pain?

  • Pain = damage?

4. Why is the pain persisting?

  • Vulnerabilities to chronic pain
  • Is there a good reason for the pain to persist? Is it useful somehow, indicating a need for more action?

5. What needs to be done?

  • Understanding — the right thinking, pain can change
  • Create the opportunity for change
  • What action is required on a moment to moment basis?
  • Development of motivational skills and resilience
  • Persistence, courage, focus, determination

This is merely an insight, and conveniently broken into sections. There is no prescription, just facts about pain that we must work with and employ within a whole-person centred approach to overcoming persisting low back pain and other persisting pain problems.

For further information about treatment and coaching programmes to overcome pain, call now: 07518 445493

* Specialist Pain Physio Clinics: Harley Street | Chelsea | New Malden

 

11May/15

The language of back pain

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The language we use when we talk about back pain is revealing and worthy of noting. This is both the language of the back pain sufferer and the clinician or therapist. Why? Because it highlights the beliefs held about back pain. Why is this important? Because the beliefs underpin the thoughts and action taken in response to the back pain.

Common descriptions that patients use when I ask them to narrate include the ‘slipped disc’, ‘wear and tear’, ‘disc bulge’, ‘worn out joints’, ‘weak spine’, ‘weak muscles’, ‘weak core’, ‘worn out spine’ and let’s not forget the range of expletives that can be attached the the above as well, ‘my ****** spine’, ‘it’s ********’, ‘when he looked at my x-ray, he told me I was ******’ — and I am not joking when I state these are just a few of the things I hear. Do bear in mind that I spend my days listening to people’s stories, making sense of their experience so that we can create a way to move forward.

And where do people obtain such language? They have been told that this is the case, they have read it on the net or heard from well-meaning significant and not so significant others. Sadly, these terms are not useful in any shape or form and in most cases create the wrong image, construct the wrong beliefs, leading to the wrong action and on-going threat and hence protection and pain (pain is about protection as regular readers appreciate).

Clinicians need to watch their language as they are in a position to deliver the right messages at key moments. This creates understanding, which emerges as behaviours and actions that are healthy and groove a way forward to overcome pain. The clinician will have a set of beliefs about pain, and perhaps suffers chronic pain himself/herself. Sticking to the facts about pain, being honest about what we don’t know, avoiding extrapolating a research finding to the populous when it has only been validated in a small number of people and focusing on the ‘cans’ rather than the limitations are just a few notable strategies. I am not going to tell you how to treat or deal with back pain here, merely highlight some observations that I have made over the years.

Back pain is a huge problem the world over and we need to think about it in a different way; a whole-person way, just like any other pain. Considering what we say, how we say it and when we say it is vital. The potency of language and communication should not be underestimated. The words we use will form an internal dialogue in the back pain sufferer’s mind, flavouring their pain perception. Let’s get it right.

Pain Coach ProgrammePain Coach Programmes for chronic and persisting low back pain — coaching you to overcome pain.

Call us on 07518 445493

 

16Apr/15

George Clooney’s back pain

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George Clooney’s back pain — Back pain can affect anyone, and does affect most at some point in a lifetime. In fact, it is probably more unusual not to suffer back pain!

George Clooney has been suffering persisting back pain since 2005 when he sustained an injury whilst filming. Reports described a torn dura that can result in severe pain, and certainly did for Clooney. With so many nerve endings, an injury will trigger excitement locally. Danger signals are transmitted from the area to the spinal cord and then to the brain–note that there are no pain signals, but rather danger signals.

It is the normal inflammatory response (the release of inflammatory chemicals) that causes increasing excitement (sensitivity) in nociceptors, reducing their threshold for firing. This means that it becomes easier to stimulate the nerves to fire the danger signals. The bombardment of danger signals causes (plastic) changes in the spinal cord that in effect operates as a volume switch.

So if all these responses are normal, how does pain persist and become chronic? This is the BIG question. The answers are complex as is a pain response, but I would argue that within this complexity lie opportunities to change pain and overcome the problems.

Pain is not a structure, it is a response to a perceived threat — very different! Pain is a response that is influenced by context, environment, beliefs, prior experiences, the state of protective systems at the time of injury, gender, intentions to move, fatigue, emotional state and more. Pain is not a disc or a joint or a dura. Pain does not come from a disc, a joint or a dura. Yes, that is where you may feel it, in that part of your body, but those structures do not have the properties of pain. Your nose does not have the properties of a common cold, yet it will stream. There is an upstream biology that involves many body systems that are designed to protect. This biology is a complex blend of all the influences I have mentioned, interpreting a situation as being threatening and hence protecting: pain, altered movement, altered thinking, altered emotions–if you suffer on-going pain, how rational are you when in pain? Can you think clearly? We lose precision.

We lose precision of movement, sense of the body, where a stimulus is being presented to the body, where we feel pain (does yours move or grow?), as well as precision of thought and emotion. Our discrete ability to plan and execute thoughts and actions is marred, ‘smudged’, blurry.

So, to the way we can overcome pain and in particular chronic pain. It has to start with thinking differently, and changing our relationship with pain. On doing so, the way that pain is experienced changes. This, alongside strategies and training the develop precision of thought, movement and sense all reduce the perceived threat. Reduce the perception of threat, reduce the pain — you are answering the demands of your body. The caveat of course is that we are not separate in body and mind. There is no separateness to pain as it is part of you, part of every cell. To overcome pain then, you must become aware of what you are currently thinking and doing (habits) and then consciously change until it becomes unconscious and normal.

Pain Coach ProgrammeThis is an insight into the Pain Coach Programme that addresses the whole person as we must to overcome chronic pain. We are constantly changing and those who suffer chronic pain have been changing towards more and more protection in response to normal activities–how many normal activities now hurt? They shouldn’t!

It is time to take the science of pain and translate it into action to change your pain. Call us to start your programme for chronic back pain or chronic pain. 07518 445493

23Mar/15

I used thirst to help someone understand pain

Back pain, chronic back pain, Chronic low back pain, Chronic pain, Understanding pain, , , ,

I used thirst to help someone understand pain. He had been given the structural explanation for recurring low back pain (trapped nerve that runs all the way to the toes), which naturally leads to a tissue based focus on ways to get better. Whilst this is a common way to describe pain, it is wrong. Pain is a protective response to a perceived threat.

Yes, if a nerve is sensitised by inflammation or injury, it will transmit danger signals to the spinal cord and then the brain. All the while, signals are being sent down from the brain to mingle with these ascending signals, the sum of which will be scrutinised by brain networks to determine whether a threat exists. If there is a threat deemed tangible, then the body will protect itself with pain, altered movement, altered thinking and altered behaviours:

  • it hurts in a location
  • you limp or limit how far you move the painful area
  • you consider how bad it is and whether you can go to the party, game, work etc
  • you don’t go to the party, the game, work etc

This is all very useful at the outset, but becomes less so as time goes on and the body is healing.

Often there is a kindling or priming effect. The first acute painful episode calms down but then recurring bouts of pain become more intense and with less and less time between–familiar? In the first instance, the systems that protect do so effectively, slowing you down and enforcing action to allow healing. This would usually be in response to inflammation, and is all entirely normal whilst being an unpleasant experience. Not nice, but nothing to worry about. Of course, you would be wise to take heed and do everything that you can to fully recover, which means that the tissues heal and the protective systems switch back to normal modus operandi. There is a chance that you will need some guidance.

It appears that there are some people who maybe vulnerable to developing on-going pain, which is on-going protection. There is likely to be a genetic aspect to this, and certainly a prior experience that may have primed the systems so that they kick in more vigorously, or simply do not turn off when they need to. An over-protect or sensitivity. The priming event(s) may happen much earlier in life so that when the body perceives a threat some years later, there is recognition of the need to protect based upon what has been learned before. Detecting this potential vulnerability is really important in the assessment so that the right action can be taken to counter on-going pain.

Back to thirst.

Where do you feel thirst? Think about it for a minute. Where in your body is thirst? It is not a dry mouth; so it is not your mouth (a dry mouth is a dry mouth and that is all). Is it in your stomach or chest? We have a sense of discomfort that can include a dry mouth, and when we note that sense we give it a meaning. That meaning is “I am thirsty’. The point of this is to motivate us to take action and seek water to quench the thirst.

The same happens in pain. We have a feeling or sensation in our body that grabs our attention. This sensation is given a meaning: this hurts, and then we look for a cause, why does this hurt? What have I done? What is going on? What are the implications, now and in the future? Naturally this happens very quickly, in a split second. The pain then motivates us to take action, like thirst. We rub, cry out, seek help.

In both thirst and pain it is the meaning that defines the experience, and whilst we feel things in certain places, it is how we think about them that gives the richness and implication. We therefore have these experiences with our whole body and self. We feel and experience thirst with our whole body, the sensation not distinct from how we then think and act. The same in pain. To se the whole creates marvellous opportunity for change, growth and moving forward. In most cases thirst is easily overcome, chronic pain being far more challenging.

Chronic pain is about on-going perception of threat as body systems adapt, we adapt and the world around us adapts. We are on a continuous timeline of development that we can influence by our knowledge, understanding and use of skills. Understanding your pain is the first step, creating a foundation for overcoming pain.

Pain Coach

Pain Coach courses for clinicians and therapists: a practical way to coach chronic pain sufferers how to overcome their pain; small group learning and 1:1 mentoring. Call us on 07518 445493

09Nov/14

My top 5 pain myths

chronic back pain, Chronic low back pain, Chronic pain, Pain, Pain beliefs, Pain Education, ,

In my view, it is the lack of understanding that causes so many problems with pain in terms of how pain is viewed, treated and conceived as being changeable. Pain can and does change when you understand it and think about it in accordance with the modern (neuroscience-based) view and have a definite plan that is followed with big action towards a vision of where the you want to be. Having seen many individuals put this into practice, I am confident that the start point is always how we think because this is from where the action emerges. The right thinking begins with understanding your pain.

In the light of this, here are my top 5 pain myths:

1. Pain comes from a ‘structure’ in the body — e.g./ a disc, a joint, a muscle.

2. The amount of pain suffered is related to the amount of damage or the extent of the injury.

3. Pain is in your mind if there is no obvious cause in the body — i.e./ via scans, xrays etc.

4. There are pain signals from the body to the brain.

5. Pain is separate from how you feel or think.

There are many others.

Now, this all sounds rather negative and I like to turn this on its head and look at how we can positively influence health in order to change pain. The programmes that I create with individuals for them to follow are all about creating the right conditions in the body systems, all beginning with the right thinking that often challenges existing ideas and notions about pain.

Struggling with pain? Persisting pain? Call me 07518 445493 | Specialist clinics for pain and persisting pain in London

28Oct/14

Top 5 back pain myths

Back pain, chronic back pain, Chronic low back pain, Chronic pain, Chronic pelvic pain, Low back pain, Pain beliefs, Pain Education, , ,

Welcome to my top 5 back pain myths. What are these you may ask?

Around pain and in particular back pain, there are many phrases and explanations used to try to educate the patient. These have been handed down through the generations and can appear to be logical. Fortunately, the science has moved on and we know better.

Here are 5 common beliefs that have been challenged:

**I have not included the myths of core stability because this has been well documented previously. Pulling in your abs does not solve the complexity of back pain, especially chronic back pain.

1. Bending is dangerous

2. Discs slip

3. Nerves are trapped

4. Pain comes from facet joints, discs etc

5. Low back pain is in isolation to everything else in your life.

Comments below:-

———————————-

1. Bending is normal. Sure it can hurt when the back is being protected, and when we have back pain the muscles are guarding and this can reduce the amount of movement. In the acute phase, most positions and movements hurt, but this is protection and it is meant to be unpleasant in order to motivate action. Moving little and often, changing position and breathing all help to keep blood and oxygen flowing.

2. Discs are not actually discs and they do not go anywhere. Yes they can be injured like any other tissue. They can bulge and affect the local environment, and they can herniate, triggering a healing response — both can hurt because protection is initiated. The fact that there are so many nerve endings around the area mean that sensitivity can arise in a vigorous manner. Again, this is a normal if highly unpleasant experience. Remember that a 1/3 of the population have such changes in their spine but without any pain. The body as a whole must rate the situation as threatening for it to hurt.

3. Nerves do not get trapped. Local swelling and inflammation can sensitise the nerves meaning that they send danger signals. There is not too much room either, so if there is swelling or a bulge, this can affect blood flow to the nerve itself and cause sensitivity to movement and local chemical changes. Again, this can happen without pain as well, so it is down to the individual’s body systems and how they respond. Understanding, gradually moving and breathing can all help ease you through this phase.

4. Pain is whole person and involves many body systems that are protecting you. There is no pain system, pain centre or pain signalling. Pain is part of a protective response when the body deems itself to be under threat. We feel pain in the body but the underlying mechanisms are upstream of the body part that hurts. To successfully overcome pain we must go upstream as well as addressing the health of the body tissues.

5. Low back pain is embedded within your lifestyle. It is not separate to how you live — e.g. lack of exercise, postures, work, stress, emotional state, previous experiences, understanding of back pain, gender, genetics, just to name a few. This maybe more complex, but this provides many avenues for overcoming pain.

Suffering with persisting back pain? Have other seemingly different problems such as irritable bowel syndrome (IBS), headaches, migraines, other joint pains, muscular pains, pelvic pain, jaw pain, recurring bladder infections? Contact me today to learn how you can move forward and overcome your pain: 07518 445493