What You Should Know About Back Pain.

1/ Persistent back pain doesn’t relate to a worsening in ‘damage’.

Instead, persistent pain is associated with the following: A negative mindset on your ability to recover Avoiding certain movements and a lack in confidence in your body’s ability to move Poor pain coping strategies

2/ Lower back pain rarely requires a scan.

Clinical outcomes are not improved by sending you for a scan.Treating the symptoms and your pain presentation has a far better outcome. A scan will not change your treatment direction or the likelihood of future back pain. I think over the duration of my career I have sent 2 people for a scan and this was to rule out red flags or anything sinister not to find the cause of a patients pain or symptoms.

3/ Back pain is not caused by a weak core.

Core retraining and strengthening definitely can play a part in your rehab however a “strong core” doesn’t mean your spine is “stabilised”. So leave out the awkward draw in manoeuvres and bracing your core to stabilise your spine. It is ok to train your pelvic tilts, dead bugs and bird dogs but the idea behind this is a gradual loading program for your back rather than selectively activating your deep muscles to stabilise your spine. The concept of an unstable spine doesn’t benefit anyones mindset.

4/ Our inner world of thoughts and emotions effects our back pain. Pain felt is strongly associated to what is going on in our life. Stress, anxiety, depression, lack of energy and sleep are all highly linked to an increase in back pain symptoms.

5/ We self-manage most of the time so make sure your Physio enables you to do it well with the right advice and education.

Role of a Physio: Reinforce positive beliefs and provide you with the facts (most back pain episodes will improve with time and treatment - even the most severe scenarios I have seen have improved without surgery). Identify strategies to mange your pain and prevent any other interventions Identify any other contributing factors and refer on as needed Individualised rehab focusing on returning you to exercise, social activities and work

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