is one of the most common complaints I hear about as a physical therapist. On the positives, 80-90% of episodes of low back pain resolve within 2 -3 months (Hides et al. 1996). Of the 5-10% that do develop chronic low back pain, 85% are classified as \u201cnon specific low back pain\u201d (Dillingham 1995). This infers that there is no specific entity that anyone can point to, and say this is causing your pain.<\/span><\/p>\n <\/p>\n Current research\u00a0suggests that there are a variety of factors working together to evoke the feeling of pain. Note I said \u201cevoke\u201d pain. Pain is a response to a stimulus as opposed to being caused by something. Say you quickly bend down to pick something off the floor and immediately feel a twinge in your back. What just transpired\u00a0is, you bent over quicker than your body anticipated, small receptors in the soft tissue\/joints in your back sent a signal to the spinal cord and said, something is not right here, I don\u2019t usually have to move this quick.\u00a0The spinal cord then relays this message to the central nervous system in your brain\u00a0which then decides if this is a threat or not. If it decides its a threat it will tell the spinal cord, yea don\u2019t like this, send this pain signal along to the tissues\u00a0in the back and also tell them to spasm so this guy doesn\u2019t move his back for a while. What results is a stiff and painful back!<\/p>\n <\/p>\n What researchers believe\u00a0happens in cases of chronic low back pain is, how the brain\u00a0perceives\u00a0a threat is influenced by attitudes\/beliefs, previous experiences, psychological distress, cultural factors, social\/work environment sensory input from body and expectations\/consequences about pain or danger of pain, (Moseley 2003).<\/p>\n So in the above example it seems fairly harmless, you\u2019d expect the pain to settle in a day or two. However, what if this is an 80 year old man, who had worked as a manual labourer for most of his adult life, lived alone and had a fear of losing his independence. Added to this is his belief that (common misconception) if something is sore you shouldn\u2019t move it or it will get worse. This is a very different scenario in which the brain has to process input from all these different factors. Now a few days later and the muscle has calmed down and is back to normal, but due to the other factors previously mentioned pain signal are still being sent to the tissues. In this man\u2019s brain a connection between his back injury and all these factors have occurred which are now driving his perception of pain.<\/p>\n <\/p>\n In this example this man is experiencing real pain even though the tissue has healed. What\u00a0he thinks is causing his pain and what is actually causing his pain is more complex\u00a0. Therefore if he or his\u00a0therapist\u00a0doesn\u2019t know what is causing his pain how is he going to\u00a0become pain free. Hence it is very important for therapist\u00a0and clients\u00a0to be aware of other factors that might be contributing to the experience of pain.<\/p>\n Things to keep in mind the next time\u00a0you have a twinge: it will probably settle in a few days, keep moving, pain doesn\u2019t mean damage, worrying about it will only increase your pain, your back is very strong and is very rare to cause\u00a0permanent damage.<\/p>\n <\/p>\n Dillingham T. (1995). Evaluation and management of low backpain: and\u00a0overview.\u00a0State of the Art Reviews,<\/em>\u00a09(3):559\u201374<\/p>\n Fersum K, O\u2019Sullivan P, Skouen J, Smith A, Kvale. (2012). Efficacy of Classification-based cognitive Functional Therapy in Patients with Non-Specific Chronic Low Back Pain: A Randomised Controlled Trial.\u00a0European Journal of Pain,<\/em>\u00a01-13<\/p>\n Hides J, Richardson C. \u00a0Jull G. (1996). Multifidus Muscle Recovery is not Automatic after Resolution of Acute, First-Episode Low Back Pain.\u00a0Spine<\/em>\u00a021:23: 2763-2769.<\/p>\n Jensen I, Bergstrom G, Ljungquiist T, Bodin L. (2007). A 3-year Follow-up of a Multidisciplinary Rehabilitation Programme for Back and Neck Pain.\u00a0Pain<\/em>, 115: 273-283<\/p>\n Louw A, Diener I, Butler D, Puentedura E. (2011). The Effects of Neuroscience Education on Pain, Disability, Anxiety, and Stress in Chronic Musculoskletal Pain.\u00a0Archives of Physical Medicine Rehabilitation<\/em>, 92:2041-2056.<\/p>\n Louw A, Puentedura E. (2011). A Neuroscience Approach to Managing Athletes with Low Back Pain. Physical Therapy in Sport, 13: 123-133<\/p>\n Moseley L (2003). A Neuromatrix Approach to Patients with Chronic Pain.\u00a0Manual Therapy,<\/em>\u00a08:3;130-140<\/p>\n O\u2019Sullivan P, Lin I. (2014). Acute Low back Pain, Beyond Drug Therapies. Pain Management<\/em>\u00a0Today, 1(1): 8-13<\/p>\n Wong W. S., Lam H. M. J., Chow Y. F., Chen P. P., Lim H. S., Wong S., Fielding R. (2014). The effects of anxiety sensitivity, pain hypervigilance, and pain castrophysing on quality of life outcomes of patients with chronic pain: a preliminary, cross-sectional analysis.\u00a0Springer. Quality Life Res<\/em>. 23:2333-2341.<\/p>\n Zusman M. (2013). Belief reinforcement: one reason why costs for low back pain have not decreased. Journal of Multidisciplinary Healthcare. 6: 197-204.<\/p>\n Zusman M. (2011). The Modernisation of Manipulative Therapy. International Journal of Clinical Medicine. 2:644-649<\/p>\n Zusman M. (1988). Structure-orientated beliefs and disability due to back pain.\u00a0Australian Physiotherapy<\/em>. 44: 1: 13-20.<\/p>\n","protected":false},"excerpt":{"rendered":" Low back pain is one of the most common complaints I hear about as a physical therapist. On the positives, 80-90% of episodes of low back pain resolve within 2 -3 months (Hides et al. 1996). Of the 5-10% that do develop chronic low back pain, 85% are classified as \u201cnon specific low back pain\u201d […]<\/p>\n","protected":false},"author":1,"featured_media":1919,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[19],"tags":[],"class_list":["post-1916","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-back-pain"],"acf":[],"_links":{"self":[{"href":"https:\/\/liberatingsolution.tech\/design-demo\/leinster-physical-therapy\/wp-json\/wp\/v2\/posts\/1916","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/liberatingsolution.tech\/design-demo\/leinster-physical-therapy\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/liberatingsolution.tech\/design-demo\/leinster-physical-therapy\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/liberatingsolution.tech\/design-demo\/leinster-physical-therapy\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/liberatingsolution.tech\/design-demo\/leinster-physical-therapy\/wp-json\/wp\/v2\/comments?post=1916"}],"version-history":[{"count":0,"href":"https:\/\/liberatingsolution.tech\/design-demo\/leinster-physical-therapy\/wp-json\/wp\/v2\/posts\/1916\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/liberatingsolution.tech\/design-demo\/leinster-physical-therapy\/wp-json\/wp\/v2\/media\/1919"}],"wp:attachment":[{"href":"https:\/\/liberatingsolution.tech\/design-demo\/leinster-physical-therapy\/wp-json\/wp\/v2\/media?parent=1916"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/liberatingsolution.tech\/design-demo\/leinster-physical-therapy\/wp-json\/wp\/v2\/categories?post=1916"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/liberatingsolution.tech\/design-demo\/leinster-physical-therapy\/wp-json\/wp\/v2\/tags?post=1916"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}So Why Am I In Pain?<\/h3>\n
The Brains\u2019 Evaluation<\/h3>\n
What\u2019s really Happening<\/h3>\n
Bibliography<\/strong><\/h3>\n