The Good News About Back Pain!
Dealing with back pain is hard. The pain is often quite severe, it can be debilitating, and you may find that it’s challenging to feel optimistic about how you will feel in the future.
You may find yourself thinking; “If it hurts this bad now then how bad is it going to get when I’m older?”. But who can blame you for thinking this way? You probably know people who have struggled with back pain for years with no resolution and it’s not unlikely that somebody has told you to expect the same.
Maybe you were told it looks like the spine of an 80-year-old. Maybe you were told the damage to your spine is only going to worsen over time. Maybe you were given an intimidating diagnosis like osteoarthritis, degenerative disc disease, sciatica, or spinal stenosis. How could we possibly expect you to be optimistic when confronted with such a difficult situation and such a threatening description of your back?
A major issue with language like this is that, firstly, it is outdated, and secondly, being told negative information about the state of your body can actually make things worse than they are. In the past, physical diagnoses being the sole cause of pain was the accepted theory in the field. As research advanced over the last 20 years it has become clear that focusing exclusively on the physical aspects of pain was missing a gigantic piece of the puzzle. Further, telling people in pain that their pain is due to a physical problem creates a “nocebo” effect.
The term “placebo” is used regularly. A perfect example would be giving somebody a pill that does nothing but it creates a positive change because the person taking it expects something good to happen. A “nocebo” is the opposite. It’s when someone tells you negative information about your body that isn’t actually a problem, but it leads to a problem because you’re now expecting that something bad is going to happen to you. By hearing people you trust blame your pain experience on a physical diagnosis you can end up experiencing persistent pain because they have accidentally created a “nocebo” effect.
The important takeaway from this information is that since pain isn’t purely physical we have many different avenues we can focus on to help resolve it. If the importance of the physical changes going on in your body is overstated, it is completely reasonable that past attempts to reverse those changes have failed and potentially led you to conclude that nothing can help you.
Hopefully, by the end of this blog, you will walk away with a more hopeful outlook.
So, if you’ve read this far looking for good news here it is:
The causes of back pain are incredibly complicated but the recovery plan doesn’t have to be. Whether you’ve had back pain for a week or 25 years it doesn’t mean you’ve run out of time to make positive changes. Even if you have received a lot of threatening health information in the past, your pain may not necessarily be due to a specific physical cause and your body may not need any physical changes in order to feel better.
Usually, pain is explained to people as your body trying to tell you that something is damaged. Logically, experiencing pain every day might cause you to worry that when your pain is aggravated that you are doing more damage. This also makes sense to most people intuitively. If you fall and scrape your knee, it hurts.
Thankfully, in recent years our scientific understanding of pain has advanced significantly. Gone are the days of thinking that pain is a telltale sign of a serious problem. Experiencing back pain is very normal. Most people will experience back pain at some point in their lives, and for most of those people, it will resolve on its own within 3 months.
But what if that hasn’t happened? What if it won’t go away? That doesn’t mean that you are broken. Thanks to our new understanding of pain it is clear that damage contributes to pain, but it isn’t the sole cause. It could be influenced by many different factors. Anything from stress, to fear of particular movements, to lack of sleep, to financial instability.
So why is this all good news? Having a variety of factors that contribute to your pain means that there are many different aspects that can be targeted to help relieve it. In the past, our strategy for resolving back pain was to get imaging done, find a physical problem, try different therapies with varying levels of success, do surgery to fix the physical problem, and then hope that you feel better. But after all that many people still don’t. Many people have even had imaging done and no physical problem was found and at that point nobody knew what to do next.
Now that we understand the complexity of back pain, it means we can try many different strategies. Even if there is a physical problem, it doesn’t have to go away for you to feel better. Someone with arthritis, degenerative disc disease, or any other diagnosis can return to a pain-free life without even fixing the diagnosed problem. There is a huge percentage of the population walking around with one or multiple of these conditions and they don’t even know about it! If pain was purely physical, they would all be experiencing persistent back pain.
So what can you do?
Rather than trying to fix the physical problem which can be very difficult, invasive, and often ineffective; you can return to a regular pain-free life focusing purely on other lifestyle factors. Any generally healthy behaviour will help. Maybe it’s eating better, exercising more, reducing stress, getting better sleep, meditating, or trying a new hobby.
The rehabilitation community has come a long way from the days of always blaming every injury on a physical problem. We have also become aware that a physical problem doesn’t mean that people are doomed to a life of pain.
Living with chronic back pain is hard. It can affect all parts of your life.
My hope for you is that you won’t give up even though the pain has been so challenging up to this point. No matter how long you have had pain, whether it has been a week or decades, there are still things that you can do to feel better. As long as you stay optimistic, you try your best to take on healthy habits, and you don’t let the pain hold you back from things you want to do, you’d be surprised how much progress you can make.
When we treat pain as a purely physical experience it makes it difficult for people to get better without fixing the physical problem. Thankfully, there is a lot more that can be done for you. Pain is extremely complex, but feeling better doesn’t have to be.