How to ‘unlock’ your troublesome back pain

Gentle exercise building up to a more vigorous regime can prove beneficial for those with dodgy backs, says Lisa Salmon.

IT can be natural for people with persistent back pain to avoid being active, for fear of making things worse, but often, this can be counter productive.

As Grahame Brown, a consultant in persistent musculoskeletal pain, and David Rogers, a physiotherapist who specialises in spinal pain, explain, tissue and muscle injuries heal within weeks, and even fractures usually get better within a few months. 

So injuries alone don’t give us the full picture, when it comes to chronic back pain.

The duo, explore this further in their new book, Back To life: How To Unlock Your Pathway To Recovery, which they hope could help those with persistent back problems to better understand their symptoms and ultimately “get their lives back”.

Research based on MRI-scan findings suggests 90% of people in their 60s who have never had bad back pain have degenerating discs, and more than 50% of people in their 40s who have never experienced bad back pain will have disc bulges, along with 20% of people in their 20s.

“Many common findings on an MRI scan are just as likely to be found in people who have never had an episode of back pain,”say the authors.

“The link between common spinal changes as identified on MRI or X-ray and persistent back pain and poor function is weak,” they say.

Changes such as degenerating discs can, of course, contribute to back pain, but the point is, they don’t tell the whole story about why it sometimes persists.

“For a long time, health professionals have believed persistent pain is due to a long-term injury that hasn’t healed. People will have been told this and naturally assumed it to be correct,” says Rogers. 

“However, more recent evidence, particularly in the field of neuroscience, has helped us to understand that ongoing persistent pain has less to do with actual ongoing injury and more to do with the sensitivity of the nervous system.”

He says injured tissue naturally heals in a fairly short time — skin within a few days, muscles, ligaments and tendons within weeks.

“It’s really important to understand that the body repairs itself from injury within a few months at most,” Rogers says. 

“For a variety of reasons, the volume dial for pain in the nervous system remains set at a high level, and although it feels like the tissues are still injured, it’s highly likely they aren’t.

“The signalling system between the injured area and the nervous system and brain is the system responsible for an ongoing pain. Therefore, if there is no actual injury or ongoing tissue damage, it’s safe to get going,” he says.

BACK TO LIFE: Keen to ‘unlock’ your troublesome back pain? Here are some of David Rogers and Grahame Brown’s top tips.

* Do activity gradually and expect to feel worse initially. This is normal. Don’t overdo it, and review your plan weekly.

* Start simple, low-level cardiovascular, strengthening and stretching exercises, building up gradually.

* Stress can affect recovery and should be resolved if possible.

* Staying in work is likely to help your back, because research shows having a purposeful role leads to people having fewer problems with daily activities.

* While medication can be beneficial, Rogers and Brown say it can be counter-productive and make recovery more difficult.

* Prioritise sleep, take regular breaks during the day.


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