Pain And Structural Damage #BackPain
I have had quite a few instances lately in clinic whereby I had to tackle painful problems in a different way. The common theme to all of these problems was that each of the people who had pain believed that the pain was as a result of some damage that they had done to themselves. I frequently heard "the doctor says that I must have hurt myself in some way to cause this pain", "Something must have been pulled or torn for this pain to appear", "Its my lower back, the scans show that I have a big bulging disc down there and I have been having trouble with it on and off for a few years".
As a therapist who works with chronic problems, I am no stranger to hearing things like this. And every time I do hear something like this I recognise that the people who say it to me are worried, are afraid and very often are just waiting for me to confirm what they already believe about their body.
According to the latest research, pain does not equate to structural damage. That means that the following scenarios are possible:
To have no pain and to have structural damage in the body
To have pain and to have structural damage in the body
To have no pain and to have no structural damage in the body
To have pain and to have no structural damage in the body
In fact, if we were to MRI everyone that we met, according to some studies roughly 50% of them would have issues with spinal discs and yet they would have no pain! And there is also the possibility that a structural issue may be causing pain, but it is most definitely not the only reason why a person may be experiencing pain.
Whilst back in Ireland recently, I was treating some people to help them with pain. I was told by one person that they had a major issue with their lumbar discs and that they were constantly living in fear of it reoccurring. Unfortunately this person had experienced a painful episode a few days prior and was in quite a lot of pain.
After explaining to him that pain does not always occur because of structural damage, and that very often (up to 66% according to a recent study) disc bulges/herniations can spontaneously reabsorb without any need for surgical intervention, he became visibly happier and less fearful about his back.
We then did some treatment in which we worked on areas of his body that our assessments revealed were influencing his ability to move freely. He left pain free, with much improved range of motion and with a huge smile on his face saying "I can feel a big big change in me after your help today, Thank you very much!"
Sometimes, the beliefs that we have about pain are supportive and sometimes they are not. We know that the perception of threat (internal or external) is a contributing factor in the generation of pain. Unsupportive beliefs can contribute to increased threat for a person in pain. That is one major reason why I aim to educate people in clinic about their bodies, about their pain and to help them to adopt more supportive beliefs where possible.