Times are changing in the world of rehabilitation and especially in the regard to managing back pain. What we once thought was good practice simply isn’t backed up now with the best evidence (that’s the next blog). So, with this being the case, what steps can you take to manage your own back pain?
From my experience, we tend to get way too focused on the actual injury diagnosis and what we can’t do rather than what we CAN do. We seem to like a label for our issue. I often hear things like,
Client: “Hi I’m Bob and I’ve been told I’ve got an L4/L5 / disc bulge. I’ve been treated a few times by XYZ”
Me: OK Bob, what have you been told about your condition and what you can and can’t do to help you progress things?
Client: Nothing, I just got treated a few times.
Me: Ummm (silent anger at poor past treatment) OK, are things improving now?
Client: No.
Me: OK – let’s find out how to get you pain free and find what you CAN do. I’m sure we can get you moving forward Bob.
And off we go. Educating Bob on how to help himself and giving him the confidence to move.
Here’s what I’m trying to achieve when working with clients…
Have a think or even write down the below with regard your own back issues and see if you can help yourself.
- Find a RELIEF position.
Your first job is to find a relief position or, a position where you’re not in pain. If you can find such a position then it’s a great start. If we can get you sleeping through the night even better. Sleep equals less inflammation. We want your body to be able to switch off from discomfort. Don’t give pain the chance to settle in. Studies show that most injures are well healed after 12 weeks yet pain can hang around long after. If I can find you a position that get’s you out of pain you’ll probably have confidence in me. That’s cool.
- Find What Movements Cause Pain.
As world expert Professor Stu Mcgill puts it; “Nearly always, the pain is worsened by specific motions, postures and loads.” In other words most back conditions can be made worse by certain movements, postures or loading. What’s yours? Is it bending forward – flexion? Leaning back – extension? Or is it just when you lift? If we can find out what’s causing the pain we can take action and design a program to get you stronger and keep you out of pain.
- Now Avoid Painful Movements
Now, as you’ve found out what movement causes pain – STOP doing it! Folk seem to love getting into the position that causes them the pain – maybe it’s just to check up and see if it’s still present? I call this “picking the scab” and this can really sensitise you to the injury when really, you want to be forgetting about it not reminding yourself about it!!
- Learning to Move Pain Free
If you know what movements are causing pain then we need to teach you movements that keep you away from these positions. If your job involves lifting and you get back pain then we need to look at your lifting technique and change the way you lift. This is the same in the gym. If you get pain squatting or dead-lifting then we need to modify techniques or find an alternative exercise. Don’t get me wrong, I’m not looking to avoid this movement but we need to “outwit” the body and perform the same movement but in a different manner. For example can we goblet squat rather than back squat?
- Build Work Capacity (Improving Load Capacity via Strength Training)
You now need to build up plenty of volume of pain free movement quality movement. Groove good quality movement which will hold you in good stead going forward. Remember though; any physical intervention is temporary. Take responsibility and ownership by getting strong and staying active.
If you’re keen to learn more about how we help people with back problems, we’d love to see you at our forthcoming Interactive ‘Back to Health’ workshop on Wednesday 7th June
