UNDERSTANDING BACK PAIN

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Do you feel like you are constantly in pain? Do you feel like you have tried everything but you still struggle to do the things you want to? Nervous to bend over? Scared to lift anything heavy? Concerned that you won’t be able to play with your kids?

These are statements I hear from people on a day to day basis. They have been suffering from back pain for months and sometimes years. They often think that this is the norm and this is just the way it is going to have to be.

How would it feel to know that this doesn’t have to be the case?

Did you know that musculoskeletal pain is the 3rd biggest health care expense and back pain makes up 70% of it. This number is extraordinary and then to think only 7% actually make physiotherapists their first port of call. 

This confuses me. People spend hundreds of dollars on expensive scans (x-rays, MRI’s, injections) for little to no positive outcome. These scans can actually make your condition worse. What is said on a scan does not correlate to the actual injury or the actual source of pain. For example you could have 10 people with the exact same MRI report and they could all be experiencing different levels of pain or more commonly no pain at all. 

The reason for this is because contrary to peoples beliefs pain is an output and not an input. Most people think that the amount of damage done at the source (tissue, muscle, ligament) equals the amount of pain that they will be in. This is far from the truth. 

You don’t believe me……?

How come it hurts more when you stub your toe when you are having really bad day compared to when you are having a good day? Or why can someone run away from danger when they have been injured – just like a solider in battle? 

It is because pain is an output and is effected by a multiple of sources – emotions, memories, hormones, chemicals etc. Pain messenger signals are sent to the brain from the peripheral or central nervous system where they are processed in the neuromatrix. From there pain is produced. 

What does this have to do with my back pain?

For the majority of back pain sufferers they have been experiencing pain for many years and sometimes the most simple of things set it off. Who would have though bending over to pick something up could cause a ‘disc’ bulge? Good news – it doesn’t. Your disc doesn’t just bulge for the sake of it and more often than not isn’t the cause of pain. 

What is the cause of my pain?

Good question. Often there isn’t one ‘thing’ that causes your back pain. It is generally a build up of multiple things. For the point of this article I will focus my time on only a few things.

1. You sit for too long

We know that sitting for long periods of time causes your glute muscles to switch off as they are in a lengthened position. This spells trouble because your glute muscles help you from falling face first when you bend over and unfortunately we nearly spend our whole life bending forwards – picking things from the floor, doing the dishes, playing with kids, playing sports etc. By not having your glutes there to help you out, you rely heavily on your lower back muscles. These muscles aren’t designed to lift your chest up from a flexed position. They are designed to stabilise your back and become over worked and become increasingly tight.

2. You are scared to bend over

This point relates back to what was said above about pain being an output and that emotions, hormones and memories influence pain. We know that stress produces a hormone called cortizole which is shown to effect pain levels. By having this ‘fear avoidance’ behaviour associated with movements related to your pain, you are straight away putting yourself in an elevated stress response. This fear avoidance behaviour can be extremely detrimental because it gets worse and worse. If you think it is going to hurt then it is going to hurt which then makes you not want to do it again and again, and the cycle continues. 

This topic can be very hard to understand but in all honesty is the most important to, not just for back pain but for all pain. Please click here if you would like to book an appointment to see one of our physio’s.

3. You don’t move enough

Sitting, standing, lying or what ever position you are in, you need to move. By being in a stationary position you are putting stresses through parts of your body that aren’t designed to withstand that level of stress. You need to move and move often.

How do I help my back pain?

1. The most important thing to help back pain is to understand what pain is and to understand what sets off YOUR back pain. This allows you to control or manage the external factors that may be influencing your back. Let’s take stress as an example. For a lot of people stress sets off their back pain. They have had a bad day at work or they are stressed for one reason or another and then they go to pick something up or twist funny and bang they have ‘done’ their back in. It wasn’t the twist or the bend over that caused the ‘injury’ because how many times have you done that exact same movement before? 1000’s of times. It is the external factors that have caused the pain response.

So in short understand what sets off your back pain and put things in place to mange them and work through them. 

2. MOVE!!

Add in as little as 20-30 minutes of gentle exercise per day and you will be amazed at how much of a difference this makes. If you want a bigger bang for your buck, schedule the exercise an hour before you normally get sore. This will reduce the stress that has been put through your body and may even change the state of your mind. As an example, lets say your brain is programmed to experience pain at 4pm just because that has been happening for years. Try going for a walk at 3pm and see if this makes a difference.

3. Strengthen your glutes

By building glute strength you are taking load off of your lower back. You are actually using your muscles to help support you rather than relying on your back. There are also a multiple of other reasons why flute strength is important especially in the athletic population but I will leave that for another post.

In summary:

Lower back pain isn’t the norm and just because you have been in pain previously doesn’t mean you have to be in pain in the future. It shouldn’t limit your ability to play with your kids, do the house work, exercise with friends or play sport. There are a multiple of reasons why you can be experiencing back pain but the most important thing is to understand what is causing your pain and develop a plan on how to overcome it.

Nick Hunter

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