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Back Pain (National pain week)


Hi guys, Nick the Osteopath here and today for National Pain Week I’m going to talk a bit about pain and some of the mechanisms which cause pain to persist longer than it should.

Pain is an output, not an input. If you cut your finger, your body detects a stimulus which travels up to your brain, its then processed along with your beliefs, past experiences and the context and the descending response is pain, so it can be either dampened or amplified depending on a number of factors.

Unfortunately, pain is a part of life but acute pain is normal and serves a purpose but in chronic or persistent pain, the pain is dysfunctional and it lasts far longer than it should and can sometimes be debilitating.

Pain can be a little like hunger. Hunger drives us to eat when it is time and our body needs fuel, as pain drives us to change our behaviour when we are doing something that may be harmful. However just as some people have an excessive hunger drive which leads to weight gain, others can become sensitized to pain and movements or stimulus that may only cause minor pain normally can become extremely painful

This can then lead to maladaptive pain responses such as excessive muscular guarding and avoidance of certain movements which leads to a vicious cycle of worsening function and pain.

A big thing to realize is that pain doesn’t always mean that there is damage but that the system is sensitized. This is akin to the smoke alarm going off when you boil the kettle, or the pain you feel when you touch sunburn, it’s not necessarily causing further damage, but the structure is tender and sensitive.

Something which resonated with me when reading recently was that we often think of ourselves as a machine and that pain is indication of damage to the machine. If you imagine a car driving with 3 wheels it doesn’t paint a very pretty picture in your mind. In reality we aren’t machines we are living, breathing, adaptable organisms and we respond positively to physical stress when the dosage is appropriate. Conversely we de-adapt when there is no stress. Since many of us are quite sedentary over time we become deconditioned, our tolerance for physical stress is reduced and we can start to develop pain.

What’s the solution? A guided treatment plan under the care of a practitioner who can address the predisposing and maintaining factors such as weakness and dysfunctional

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