Over my increasing number of years in practice I have developed an appreciation for the multi-factorial nature of back pain. It has become more and more clear to me that aside from the physical things that cause low back pain–stiff joints, tight muscles, movement dysfunction, etc–that a person’s mental state can positively, or negatively impact their pain.
While I am not trying to insinuate that pain that does not relent to conservative and medical interventions is “all in your head,” I would like you to consider the distinct and evident possibility that your head is definitely in your pain.
Fear of movement, anxiety, and helplessness are all factors which have been identified as having a negative effect on patient prognosis as it relates to low back pain. Removing these things from the equation should be a priority when approaching treatment, and I hope to outline approaches to doing just that.
To first address fear of movement, it is important to consider that most up to date evidence-based approaches to low back pain no longer recommend bed rest as it has been found to be ineffective and even harmful to those suffering from back pain. While you should be considerate of the types of movement you participate in, it is generally a good idea to keep moving if you want your pain to improve.
My guess that most of the anxiety that comes with low back pain is centered around its implications of seriousness as far as health issues are concerned. The facts show that this tends to not be the case. For a typical person suffering from low back pain, there is a 90% or better chance that it is not due to something serious–i.e. life threatening–like cancer, infection, organ problems, etc.
Lastly, in regards to addressing helplessness, I think it is important to recognize and appreciate the incredible healing capabilities of the human body. Doctors, surgeons, chiropractors, and physical therapists can nudge your body in the right direction to heal, but ultimately success and resolution of your pain will come from within, one way or another.
To combine all of these thoughts into an easily digestible and hopefully therapeutic idea I have come up with a back pain mantra which you may use to remind yourself of them. It is as follows:
My back is strong, stable and resilient.
My back is healthy, and pain-free.
There is limited but encouraging research supporting the use of mantra for reducing pain and increasing function for various musculoskeletal conditions. Its success likely lies in the fact that it is a form of mindfulness meditation, which has also been shown to be beneficial for those who suffer from chronic low back pain. I encourage you to repeat this mantra as often as you like, or modify it to your liking.
The most you have to lose is a few minutes of your time, and maybe believing in yourself for once 🙂