But, what happens, when it does not get better on its own? This is where things start to falter and reasons are given for the ongoing pain which like are not true. I have written about some of these things in the past. Posture is commonly blamed, but research really does not support this: www.promotiongb.com/blog/back-pain-and-posture Sometimes, people are told that something in their back is out of place and this is the reason for their pain. Again, this has not been show to be true: www.promotiongb.com/blog/back-pain-is-something-out-of-place And then there are the beliefs that back pain is caused by degenerative disc disease, disc bulges, how we lift, and even how we sleep: www.promotiongb.com/blog/low-back-imaging-how-useful-is-it www.promotiongb.com/blog/what-happens-to-herniated-discs www.promotiongb.com/blog/is-it-ok-to-bend-my-back www.promotiongb.com/blog/sleeping-position-and-back-pain So, if the evidence is weak that these things cause or maintain ongoing back pain, then what does? The research would tell us that ongoing back pain is likely multi-factorial and and that we need to look at it and treat it from a biopsychosocial perspective. But, what does this exactly mean for you (or me as someone that helps people with back pain)? It means that the "whole" person needs to be considered with back pain. The "Bio" portion can include such things as the mechanism of injury (if there is one), activity levels/conditioning/strength/endurance, sleep, how a person moves (or doesn't move), certain positions that may be aggravating, activity modification, and any other thing that relates to the physical condition of the body that can be changed. This is where, many health care practitioners (physical therapists, chiropractors, massage therapists, personal trainers, etc) spend all their time trying to help patients. The problem with this is that more and more research for ongoing pain conditions is showing that the psychosocial aspect of an individual can also play a significant role in whether or not, or even how quickly, a person recovers from a back pain episode. The "Psycho" portion can include a person's beliefs and attitudes about their body and pain. It can also include worry, fear, uncertainty and anxiety about their condition. How well a person is coping with their pain, how they expect to recover, how much they feel they can control their symptom, and whether they previously or currently have depression have also been shown to affect recovery. Lastly, the "Social" portion can include such things as their relationships with friends and family, job satisfaction, how much emotional support you have, and how much have you kept up with doing the things in public that make you happy. I find many people who have had back pain for a long time, have stopped doing things with friends and family because of the pain and we work for ways to get them more connected again.
In my comprehensive assessment of a person struggling with back pain, my aim to to listen attentively and perform a detailed assessment so that all factors that can be contributing to their ongoing pain can be addressed if needed, to help them move forward and have a better understanding about their back and get back to living the life they enjoy.
Feel free to contact me with any questions. Thanks for reading, Bob
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