Change your brain to change your pain


I've noticed a trend with patients and people that I meet when they talk about back pain vs. other injuries. Whenever a physician or other healthcare provider has given a diagnosis regarding a back issue, that person talks about the issue in the present tense - FOREVER!! "I have a herniated disc" (It's been 2 years) or "I have sciatica" (even though they have ZERO pain right now). Sciatica means leg pain caused by neural dysfunction in the low back. How can you have sciatica if nothing is hurting?? If someone thinks they always have a back problem once they have been injured at all, how much will this affect the symptoms, pain, and thoughts and feelings regarding movement and exercise for the rest of their life? If they haven't met anyone who told them it's OK to do those things that they thought they couldn't or shouldn't be doing, these underlying assumptions are likely causing huge limitations in thousands of people's lives. This is one thing I have to teach patients all the time,  that through proper physical therapy interventions, such as manual therapy and corrective exercise, these movements you may be afraid of can be regained.

It's even more telling because these same people, telling me about their ankle, or their MCL, after they have gone through rehab (or even if they don't) use the past tense. Once the pain is gone, they return to full activity, and they had a torn MCL, or I sprained my ankle (not "I still have a sprained ankle"). Our tissues in our spine and in our limbs heal the same way, but the prevailing mental image is of lasting damage in the back that is always gonna be there, and in all the other limbs we are able to fully recover from those same things!

Part of the problem comes from websites and even textbooks that, while I'm sure are only trying to help, are miseducating by saying "don't bend forward if you have a herniated disc" or at least "be careful with flexion". While I totally agree with this after the initial injury, once a month or two has passed we need to work on bending again, otherwise it's going to take even longer to get fixed in the later stages. Our spines were meant to move and bend, just like our ankles were meant to cut and pivot. Not right after an injury, but certainly after a progressive rehabilitation program that leads up into return to dynamic activity. Almost none of these websites with this kind of "spine health" information denote a length of time that these activities should be avoided - causing countless people to miss out on certain activities, and causing increased fear of movement long after the movement is still dangerous.

These societal views on back pain are definitely contributing to chronic pain and patients suffering with issues for longer than they have to be. If back pain is keeping you from doing the things you love, call Pure Physical Therapy in Coral Gables and schedule an appointment to get back in the game.