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?
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