Chronic Pain

Pain, though far from enjoyable, is something every one of us will experience at some point in our life.   In many cases pain is acute and caused by some type of trauma, incident, surgery, disease, or illness and there’s an end in sight once the healing process occurs. Chronic pain however is a different animal as this type of pain persists sometimes days, weeks, months, or even years. In fact, you may be surprised to find out chronic pain affects more people than coronary heart disease, diabetes, and cancer combined. Below is a chart from the American Academy of Pain Medicine which depicts this comparison.

Low back pain is a common type of chronic pain frequently treated in physical therapy.In a report from the National Center for Health Statistics it was noted that:

• Back pain is the leading cause of disability in Americans under 45 years old. More than 26 million Americans between the ages of 20-64 experience frequent back pain. (6)
• Adults with low back pain are often in worse physical and mental health than people who do not have low back pain: 28% of adults with low back pain report limited activity due to a chronic condition, as compared to 10% of adults who do not have low back pain. Also, adults reporting low back pain were three times as likely to be in fair or poor health and more than four times as likely to experience serious psychological distress as people without low back pain. (6)

If you come to physical therapy for chronic back pain your therapist will typically assess your past medical history, review any reports from diagnostic imaging done, look at your posture,  assess range of motion/Flexibility/movement patterns, evaluate  muscle strength, Assess your soft tissue integrity, and review the joints above and below the back to get a sense of other deficits that may be present and impacting the  low back. Treatment is very individualized but will often focus on  educating a patient in posture, positioning, body mechanics, and appropriate adaptive strategies. Manual work will be performed to improve joint or tissue restrictions and exercises for range of motion, flexibility, strength, and stabilization will be done. Biofeedback may be tried to promote or inhibit muscle activation around painful areas and modalities for pain control may be tried such as heat, ice, ultrasound or electric stimulation. (was thinking this would look cleaner in 2 columns labeled evaluation and treament with a list of ideas under each but did not know how to format this)

A therapist’s expertise in the physical and structural components mentioned above are not always enough to either improve or eliminate chronic low back pain. Make sure to address the whole you to maximize recovery efforts as there are a range of non-physical factors such as diet, stress, fear, depression, poor job satisfaction and what people with low back pain think is wrong with their back that are at least as important in the prognosis of a person with low back pain. Chronic pain is multifactorial so make sure you cover all your bases. Assemble the best team possible to meet your needs which may include a medical doctor, physical therapist, massage therapist, psychologist, acupuncturist, nutritionist, naturopath, herbalist, chiropractor, personal trainer and/or a spiritual leader depending on your beliefs. Take a moment and let us know what helped you to improve  your chronic pain.