LET’S TALK…. People’s beliefs about their back pain and what is actually happening

Dr Matthew Franz, Melbourne Osteoapth @ City Osteopathy

In today’s society, lower back pain is often described as a result of issues built up over time with a direct cause. Sometimes this can be the case, however it’s the way we interpret our back pain and the pain science behind it that has recently come into a more prominent view point.

Louis Giffords Mature Organism Model via NOIjam.com

Have I lost you yet?

Well to break things down a little, the word ‘pain science’ can be described as “ The nervous system’s processing of their injury, in conjunction with various psychosocial aspects, determines their pain experience”. (Louw et al., 2011) The way I look at pain science myself, is the way we interpret our own pain. It can be the way we recognise it and then construct it in our mind, which then determines the way our body reacts to it, as seen above.

For example you will notice that every time you have a sore back, you won’t bend down as it tends to hurt. However over time your brain has associated this action with pain and interprets it as harmful to the body. So you don’t perform that movement to the best of your ability, which in turn develops a feedback loop.

It is crazy how many times people describe their back pain as being caused by a slipped disc or weak core. They have been conditioned to think that these are the issues that have caused their back pain. It might play a factor however its the health professionals that influence them into thinking they need constant treatment in order to feel better.

I’m bursting the bubble and telling you that back pain is normal thing! It is how we manage your back pain that makes the difference.

What are you trying to get at then?

A systematic literature review of MRI findings on people with spinal related changes in their back WITHOUT SYMPTOMS by Brinjikje, W., Luetmer, P.H., Comstock, B., et al. found that:

1. The study suggests that imaging findings of degenerative changes, such as disk degeneration, disk signal loss etc are generally part of the normal ageing process rather than pathologic processes requiring intervention.
2. That >50% of asymptomatic individuals 30–39 years of age have disk degeneration, height loss, or bulging. This suggests that even in young adults, degenerative changes may be incidental and not causally related to presenting symptoms.
3. The results from this systematic review strongly suggest that when degenerative spine findings are incidentally seen (ie, as part of imaging for an indication other than pain or an incidental disk herniation at a level other than where a patient’s pain localises), these findings should be considered as normal age-related changes rather than pathologic processes.

So what can we do about it?

My advice is to first stop worrying about the pain and look at how we can address it. Look at the the factors that may be affecting it and how can we have control over it. This allows you to gain a better understanding of what is actually going on.

I understand it may hurt and play up from time to time, however the way we view our pain will help toward healing it. This combined with proper management and treatment, staying healthy and stretching are all very important. As osteopaths we can get you to the point of feeling comfortable about your pain and hopefully get you feeling better sooner rather than later!

Dr Matthew Franz Osteopath at City Osteopathy

References

Brinjikji, W., Luetmer, P., Comstock, B., Bresnahan, B., Chen, L., Deyo, R., Halabi, S., Turner, J., Avins, A., James, K., Wald, J., Kallmes, D. and Jarvik, J. (2014). Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. American Journal of Neuroradiology, 36(4), pp.811-816.

Louw, A., Diener, I., Butler, D. and Puentedura, E. (2011). The Effect of Neuroscience Education on Pain, Disability, Anxiety, and Stress in Chronic Musculoskeletal Pain. Archives of Physical Medicine and Rehabilitation, 92(12), pp.2041-2056.