There are two things that may happen when you visit a health profesional. One, they may attempt to create dependence in you by:
1. Fostering beliefs that you are fragile - that you need to be really careful when you leave their office into the big bad world where you get damaged etc.
2. Adopting an overly structural view of the body - that things are tight, loose, out of place etc. and need "correcting" by the health professional
3. Incorporate an inordinate amount of "passive interventions" (massage, mobilisations, manipulations, needling, electrical modalities [TENS, US etc.]) to give you a short window of pain relief, but fail to address the root cause of your issue
The other thing that may happen when you visit a health professional is they attempt to create independence in you by:
1. Giving you the information about your condition so you understand it and can manage it
2. Foster beliefs in you that you are adaptable, and can become strong, robust, and resilient
3. Provide you with the tools to manage your own symptoms. That means using "active interventions" (exercise) to equip you to self-manage at home.
For example, when treating those with persistent low back pain, we will regularly refer to the evidence that suggests,
- Lower Back Pain (LBP) is extremely common
- It affects millions, if not billions of people across the globe.
- LBP is often a normal part of life
- Sometimes a brief episode of LBP is just that, a brief episode!
- Persistent LBP is getting worse, despite advances in healthcare
- This is a hard pill to swallow, but the evidence is clear that there has been no significant decrease in LBP over time.
- LBP is grossly mismanaged
- Some proposed reasons for LBPs prevalence include the routine use of low-value interventions (more on this below).
- Prudent use of medication, imaging (MRIs, x-rays, US etc.) and surgery
- Low-value treatments such as manipulations, acupuncture and dry needling, surgery, and injections are either not recommended or have very limited use in select patients.
- Most episodes aren’t serious
- However, red flags include numbness is the saddle area, bladder/bowel issues, loss of sexual function, gait disturbances, and extremely severe pain that cannot be improved.
- LBP is caused by a multitude of factors including physical, environmental, psychological and social.
- You are not your MRI – there’s more to your back pain than physical factors!
- Advice to rest and/or take time off work is normally not appropriate!
- Education and exercise are routine first-line treatments
- Education that supports self-management, reassurance, resumption of normal activities, decreased fear of movement and regular physical activity are appropriate.
- Most episodes of LBP are self-resolving, but if you’re in pain and want to see a therapist who knows the evidence, look no further than Sycamore Health. (Foster et al., 2018)
See, learning about why things hurt can actually help things to hurt less! That means, to improve your chronic pain, you need to learn about why it is persisting. For more infomration about chronic pain click here.
Foster, N. E., Anema, J. R., Cherkin, D., Chou, R., Cohen, S. P., Gross, D. P., . . . Woolf, A. Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet. doi: 10.1016/S0140-6736(18)30489-6