Lower Back pain

 

Managing Chronic Back Pain

Managing Chronic Back Pain

Chronic Back Pain? What Now


Did you know that 80% of the population will suffer from back pain at some time in their lives? For most of us, the pain and stiffness comes on after a day of unusually heavy activity. We take a couple of over-the-counter pain relievers and get a good night's sleep and that is the end of it.

But, for some of us, the pain lingers, maybe even gets worse over time. In a small percentage of these cases, doctors can actually point to a cause and might send you for some physical therapy or, in the worse cases, recommend surgery.

For most of these lingering episodes, doctors find nothing definitive or out of the ordinary and tell you they cannot find anything wrong. You just have "chronic back pain." I have two issues with this:

    Not finding anything wrong just means they don't see anything that needs further action from them. This is a good thing because now you are in control and have the freedom to try some remedies on your own without the worry that you may hurt yourself further.

    The implication is that the pain is all in your head. Doctors don't realize they are implying this but there it is. It is where our thinking goes when we hear that they, the doctors, can't find anything.

Oh, the doctor may have mentioned something about degenerative disc disease, which is often their diagnosis, and the thought that your discs are degenerating is a bit panic inducing but, worry not. Your discs have been degenerating since you turned 18 years of age. Disc degeneration is part of the aging process.

If you are fairly active with low impact activities, you have less degeneration. If you are fairly inactive, like in a sedentary occupation, or performing high impact activities, your discs are degenerating faster. And, if you have osteoporosis, you will have significant degeneration and doctors will treat that.

So, the doctor can't do anything but supply muscle relaxants or pain relief. Now we are just masking the issue instead of working toward a solution. What is a solution?

Every case is just a little bit different. The first step is to understand back pain or any pain, for that matter. Certain parts of us have more pain receptors than other parts of us: hands, feet, head, genital area, and areas around the spine. The reason for this is obvious if you think about it. Some of these parts are parts that we use to sense our surroundings: head, hands, and feet. Some of these area are important to our survival: head, genital area, areas along the spine. These parts are protected by more pain receptors than other parts. Yes, protected. Pain is a great teacher and you are always more careful when you know something is going to hurt.

Just like you can feel even a little swelling in your hands, your back can feel even a little swelling or inflammation to the areas around the spine. You have learned over the years that, under certain circumstances, swelling occurs in your hands and you pretty much ignore it or make changes that reduce the potential for swelling. Now you need to do the same thing for your back. You need to pay attention to your pain or stiffness and catalog the pain.

If you are paying attention, you will notice that some pain is more of a stretch pain. Okay, that can be good. Some pain is sharp but only occurs under certain conditions. Probably shouldn't do those things just now. Some pain is dull but it is there constantly. Paying attention to your pain can make you a very good diagnostician for your own body.

Now you need to work on your expectations. If you broke your arm and lived in a cast for 6 weeks, you would expect that when the cast is removed, the arm is severely de-conditioned, like spaghetti muscles. You would expect to exercise the arm more and more every day until you regained your prior strength, maybe even better strength because you were working at it.

This is the expectation you should put on your back pain. You probably, if you are like I was the first time I injured my back, are resting as much as possible in between the times when you have to go about your life. Maybe you have even given up some normal activities in favor of the resting of the back.

This is very intuitive behavior and probably not the best thing for your back. The first time I forced myself to walk normally even though my back was seized into a knot, I counted every step. It took eight steps. Eight excruciating steps. Well, actually, four excruciating steps, two merely very painful steps and the last two were truly bearable.

It never took eight steps again because I learned that the pain would be no worse if I stood up straight and walked normally and that over time, it might actually improve. But how could I get to the place where my back didn't seize up in the first place? This is where most of us tune out. The silver bullet is exercise, good posture, stretching, and occasionally ice.

Remember, move normally, even when you hurt and start using ice after activity

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