A guest blog from Toby Pollard-Smith<\/p>\n\n\n\n
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The simplest thing I can tell you about back pain is that it\u2019s not simple.<\/p>\n\n\n\n
Sure, there may be some simple-sounding explanations out there, but when the pain lingers beyond a few days, we must look deeper and consider more elements.<\/p>\n\n\n\n
In an attempt to find some structure amidst the chaos, I offer three steps to help my patients in their battles with persistent back pain. You might find these steps more abstract than you\u2019d like, but have a read, and consider how you might integrate them into your back pain strategy.<\/p>\n\n\n\n
Step One: Understand what\u2019s wrong<\/strong><\/p>\n\n\n\n We need a starting point. The best place to start is understanding the narrative. Therefore, when you meet a manual therapist (physiotherapist, chiropractor, or osteopath), they will want to know the story of what has happened to you, and more about you generally.<\/p>\n\n\n\n There will be clues in your narrative that help identify the nature of your injury and allow consideration of the causes. Perhaps your back pain really did come out of nowhere, but without knowing more about you, your general health, and how you\u2019re coping, it\u2019s hard to put the relevant pieces of information into context.<\/p>\n\n\n\n Next on our agenda is the dreaded term \u201cnon-specific back pain\u201d. It is often used by medics but rarely explained to patients. It simply means that your back pain isn\u2019t being caused by cancer, infection, a damaged blood vessel, or a list of other things. It\u2019s good news, but all too often, clinicians stop there.<\/p>\n\n\n\n It seems that the term \u201cnon-specific\u201d has been re-appropriated to mean \u201cdon\u2019t bother trying to understand how they\u2019ve hurt their back\u201d. But I disagree. We should absolutely appreciate how difficult it is to nail all cases of back pain down to a simple set of causes, but at the same time, we can categorise patients into rough groups:<\/p>\n\n\n\n This basic information can get us off to a good start. We also need to understand whether your pain type is:<\/p>\n\n\n\n (There\u2019s plenty more to know about these \u2013 let\u2019s just appreciate that there are differences for now)<\/p>\n\n\n\n Step Two: Find what\u2019s good<\/strong><\/p>\n\n\n\n The general idea here is to try things. Once you\u2019ve seen a good therapist and identified a few features of your back pain, you should have some starting points. Examples would be:<\/p>\n\n\n\n Examples like these need personalising to each person – they might not<\/em> be the correct tactics for your back pain. This is why I feel everyone should get help.<\/p>\n\n\n\n As much as you think you know your own back pain (and patients often come up with some great<\/em> tactics themselves), there is always value to be gained from having an external observer offer their expert advice.<\/p>\n\n\n\n This is the role of a good manual therapist, who should position themselves alongside you, not shouting down at you. They should educate you about the nature of your injury, encourage you to try tactics that should help, and can offer some tips and tricks gained from dealing with back pain patients in the past. Hands-on treatment can be helpful as well, but it should be the icing on the cake, not the cake itself.<\/p>\n\n\n\n The elephant in the room here is that things can get worse. While we don\u2019t want patients to feel worse, we must acknowledge it when it happens, and use our shared knowledge of what has happened to help better our tactics and strategy. We don\u2019t always get things right the first time.<\/p>\n\n\n\n Patients live with their pain for weeks\/months\/years, and therapists might only have 30 minutes to try and understand all the details and appreciate the patient\u2019s lived experience. It sounds ambitious. So, we need humility to accept that things might worsen (or \u201cflare-up\u201d). Let it settle, accept that it happened, remember what might have caused it, avoid repeats, at least for now\u2026 <\/p>\n\n\n\n Step Three: Stir the pot<\/strong><\/p>\n\n\n\n Hopefully, by having an idea of the nature of your back pain and by testing a set of tactics that minimise pain and maximise function, you can start to live better. This is great \u2013 real progress. As soon as we see people show any kind of improvement, we can all feel more positive about long term results. The journey might be long, but you\u2019ve set off in the right direction.<\/p>\n\n\n\n However, beware of getting stuck in the groove.<\/p>\n\n\n\n As your condition improves, and your body heals (tissues, nerves, or the short circuits in your nervous system) you need to move out of your protective mode. This needs to be managed carefully, with the correct modifications and sensible dosing to keep you heading in the right direction but picking up speed. Again, a good therapist will help you achieve this, and shouldn\u2019t merely deliver the same message\/treatment over and over.<\/p>\n\n\n\n You must accept that there will be some \u201cflare-ups\u201d along the way, but without trying to break off the shackles, you might find that you\u2019re needlessly guarding your movements. In fact, your body needs<\/em> to take the next step. If you had an ankle injury, would you still be walking with a limp long after the ankle has healed? No.<\/p>\n\n\n\n We should target a return to normal. Not everyone makes it all the way, but it\u2019s hard to make convincing excuses for not trying to head in the right direction. It can take courage, but without regular testing and listening to your body, you run the risk of getting stuck in a stagnant state of almost<\/em> better.<\/p>\n\n\n\n Final Thought<\/strong>s<\/p>\n\n\n\n I sincerely hope these pointers help bring some structure to the battle you face with your back pain. It\u2019s not simple, it\u2019s not easy. Embrace the chaos, engage in battle, change your tactics, confuse the enemy.<\/p>\n","protected":false},"excerpt":{"rendered":" A guest blog from Toby Pollard-Smith The simplest thing I can tell you about back pain is that it\u2019s not simple. Sure, there may be some simple-sounding explanations out there, but when the pain lingers beyond a few days, we must look deeper and consider more elements. In an attempt to find some structure amidst […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"off","_et_pb_old_content":"","_et_gb_content_width":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-527","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"\n