Back Pain: To move or not to move…?

Between 60-80% of us will experience back pain at least once in our life, for many it’s an ongoing problem. In 90% of cases back pain is classed as non-specific which means that there may not be a problem with any of the structures or tissues in your back and 95% of us with back pain will have a ‘spontaneous’ recovery…

I find this statement quite challenging for me personally because I am not convinced 95% do have a spontaneous recovery. It is true that a very large number of us who have back pain will feel the odd twinge now and again or may even have pain lasting for a while but it goes eventually without any intervention. Thats great but what about those of us who don’t just get better…?

Back pain then becomes something to ‘manage’, often by avoiding certain aggravating activities, lifting, bending, twisting and can even mean, time off work, giving up a well loved hobby or sport. For some of us everything we do is decided by managing the ‘risk’ of flaring up our back pain. The pain ends up dictating the terms of how we live and suddenly moving, doing ordinary day to day activity can become frightening or even the thought of going to bed is something to dread… I know I have been there!

Knowing what to do, who to trust is a challenge for many of us too! Now I am a fan of ‘Dr Google’ :-) but whilst there are some great sites and advice out there… there is probably 5 times (ok I am guessing but you get my drift!) as much rubbish and quite frankly scary stuff too. So it’s important that if you are looking for advice that you look at sites that are linked to the NHS, the CSP (Chartered Society of Physiotherapy) or check that the person who has written the advice has relevant qualifications AND experience. But most of all if it seems like nonsense it probably is!

Now I want to tackle the other font of all knowledge all those well-meaning friends, work colleagues and family members who have had back pain or know someone who had back pain…! Everybody is different – there is no one size fits all ‘cure’. I have been practising physio for 18 years (and had years of back pain myself) and trust me two people can turn up to my clinic with exactly the same symptoms in the same place BUT the reason they have pain there could be for completely different reasons. So I would need to advise and treat them differently.

So if you have tried your friends therapist, exercises or advice and it hasn’t worked don’t worry and don’t be surprised. It’s very very unlikely that there is anything serious going on (1% of back pain has a serious pathology) it’s very likely you just need a different approach, advice or exercises.

So what should you do if your back pain isn’t going away…?

So having said there isn’t just one way of dealing with back pain you will be pleased to know that there are exercises and advice that can be useful for anyone with back pain, no matter matter the cause or how it behaves or affects you :-)

Spines are designed to move!

Fortunately, we now realise the importance of keeping active through a variety of exercise, to keep our backs healthy and how avoiding activities or certain movements can actually make pain worse. Trust me when I first started we still gave out braces… :-(

How do we move and why does it sometimes hurt?

Movement is a highly organised affair with subtle timing between muscles, joints and nerves, co-ordinated by the brain to perform a task. In other words we don’t move for the sake of moving, it is purposeful. In order for the movement to happen we need joint that move freely, muscles that can shorten and lengthen at the appropriate time to ‘control’ the joint movement and nerves that are able to slide and lengthen. It sounds complicated but our amazing bodies do it all the time, mostly without any problems.

However, sometimes pain can be experienced when one of these ‘systems’ isn’t working as effectively as it should be. This can lead to uneven stress and strain on either our muscles, joints or nerves – we experience pain basically as an early warning sign to do something about it so we keep all our tissues healthy.

Fear of pain or moving can create more pain too. If we think it’s going to be painful in often will be..! This is for a couple of reasons;

1) when we are fearful we set up our fight, flight, freeze response which releases adrenaline into our bodies, reduces blood supply to the extremities and causes our large muscles to stiffen (this happens in our bodies quicker than your brain can recognise it) creating a bracing strategy leading to more pain

2) this creates or reinforces the belief that movement is painful so you move less.

Movement is key!

All our tissues (muscles, joints and nerves) love movement! It helps with blood supply and oxygen to the soft tissues and nerves, keeps the fluid inside the joints moving and strengthens our muscles which support our spine joints. It also helps lift our mood and to get a good nights sleep, which is important for regulation of the bodies systems such as our immune system and hormones.

But which activity is ok and which is not..?

My general advice to any of my own clients who have back pain is to keep active, doing whatever they are doing at the time of seeing me. Often pain can have what we call a latent response – so you do something and you don’t have pain until that evening, next morning or even longer after – this doesn’t mean you should stop it just means you may want to vary your activities at bit more. Just while you are working on reducing your pain in the long-term.

Your spine is incredibly strong and designed to move – it is NOT fragile :-) BUT I know from personal experience how painful it can be. I also know that getting the right advice and the right support and encouragement can make the world of difference.

Find this useful but would like to know more?

Then join me at one of my Back Pain Workshops where we talk facts NOT fiction! Find out what slipped discs, wear & tear, degenerative changes really mean and what CAN be done!

Click Here To Join Me At My Next Back Pain Workshop (No training kit required!)

Jenny Manners MCSP MSc
Principal Physiotherapist
Meadowhead Physiotherapy

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