Lower Back Pain - Your Thoughts and Beliefs are Crucial

If you are trying to get control of your back pain there are five important things to consider.

• improve your posture,
• increase flexibility
• Improve your fitness
• strengthen up your core muscles.

But the fifth really important point is:

Ensure that you have no unhelpful thoughts and beliefs about your back problem.

Sorry, I don't want to shout at you but I think this is so important. Let me explain a little more about pain and some of the factors that affect it. Hopefully, that will shed some light on why I think this is so important.

The first thing to know is that the science of pain is not straightforward - even experienced medical professions don't understand everything about it. We are learning new things all the time. Over the years our understanding of what causes uncomfortable sensations and makes them last for some people has changed a lot. Many of the things we thought we knew are not true. We have had a surge in our learning recently, with advances in science allowing us to look at the brains of people in a functional MRI, this shows us where the brain is active when we think and has transformed the way we view pain. Furthermore, studies on people with back problems are increasingly highlighting the need for us to think about thoughts and beliefs as they can be unhelpful and can worsen the problem considerable.

Up to date thinking challenges some of the things we may take for granted . I have written a section on how our understanding of the science has been redefined. If you don't understand how uncomfortable sensations are felt it will be hard to follow the important sections on how your thoughts and feelings can affect you.

Recent research tells us that the experience of discomfort is a combination of biomedical (tissue based), social and psychological factors. This is known as the biopsychosocial model.
I meet people who are upset and angry because they have been told that their discomfort is all in their minds. The biopsychosocial model may help explain why this misunderstanding may have happened.

Over the last decade, as our understanding of the biopsychosocial model has deepened, a lot of effort and research has looked at the effects of how we think and feel on our back problems. A number of thoughts, beliefs and behaviours have been identified that increase your chances of becoming distressed and disabled by chronic lower back problems. These are called yellow flags.

These pages explain what yellow flags are and outline some of the features of a few of them, in particular

• fear avoidance,
• catastrophising or fear of the future
• beliefs about diagnosis and causes of lower back problems .

If these 'yellow flags' are not addressed then treatment for lower back symptoms is often unsuccessful.

It is complex and I know I'm going on a bit but I would recommend that you try and read all the pages linked to this section so that you have a good overview of up to date thinking and research about the science of pain.

Next - Pain Redefined - more on how modern research has blown conventional thinking out of the water.

My favourite book - most highly recommended

I am delighted to see my favourite book for sale at Amazon at long last. In my opinion It is the best book you can get if you want to learn more about your back problem. It is written for both patients and professionals and is worth every penny.

20-Nov-2009