The study of Pain Science is an extremely complex and intimidating realm of healthcare. While many specialties can argue that they hold more knowledge than that of other healthcare counterparts, the science of pain is a relatively new aspect of healthcare. Amazing breakthroughs in regards to understanding how the brain and body interpret pain have only occurred in the last 10-15 years and the healthcare community is learning about it at the same rate. And while great strides in understanding pain are taking place, the over prescription and abuse of opioids continues to grow.
Research continues to show and reinforce the fact that in the event of low back pain regular utilization of Physical Therapy can alleviate symptoms faster and more effectively with longer lasting results than injections, medications, etc.
The general belief regarding back pain is that the spine has become compromised and additional movement, in any form, is going to cause further damage. And as a result of this belief, patients and clients have been taught to brace their spine, to make it rigid and unmoving and to never move in specific ways (squatting, twisting, side bending, lifting, etc.) ever again. The hardest part of treating someone with chronic pain is not how to move but that they can move the painful area. Care must be taken to explain, cue and prescribe appropriate corrective motions and exercises but the look of pain free disbelief is quite rewarding.
Changing this belief system and mindset, regarding pain, is the first step in reducing the demand for pharmaceutical intervention. Lorimer Mosely, a world-renowned Pain Scientist and Physiotherapist, in regards to pain explains that "If we continue to run neurons that produce pain, they get better at producing pain, they become more and more sensitive...so we need a smaller and smaller influence. This illusion of sensitivity (produced by the brain) becomes very unhelpful. It's trying to protect you from something that's not needing protection. As sensitivity increases, all of these networks lose their capacity to be specific and precise, so the pain spreads and changes its quality. The pain is no longer informative."
Recently, I treated a client who had not been able to sit down comfortably for 2-3 weeks due to pain despite attending Physical Therapy elsewhere. Reluctant at first, he performed what was asked of him and listened attentively as he was provided a brief explanation of pain science and how it related to his symptoms. Upon leaving he noted that he felt fewer symptoms but indicated that "it's still there". A few hours later he returned to the office, not because symptoms had returned or increased but because he wanted to show off how easy it was to sit...and stand...and sit again.
TED Talk Regarding Pain Science - Lorimer Moseley
Low Back Pain - Peter O'Sullivan