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"It’s flared up again”, “I bent over and it went ping again”, “I was just getting out of the bath!”, “I went to tie my shoe laces”, “I leaned over the couch to open the window because I burnt my muffins”. These stories are common place here in Cardiff. Back pain is a complex topic as there is very rarely one cause of chronic back pain that we can figure out, eradicate and get it to be gone forever.
By the time back pain has reared its ugly face there was already a problem. Think of it like a kettle, it was slowly brewing in the background, bubbling, getting hotter, steaming and then the switch goes off. This switch is what causes the initial pain a person feels and causes people to seek treatment in many cases. Our brain is a highly tuned instrument to detect danger and this relates to pain too. If the brain thinks a part of your body is in danger then the pain response can be activated to protect you. Unfortunately the brain can do this too well and leave us feeling in pain for long periods of time which in turn can produce more negative effects. Studies have shown that pain does not always mean that there is damage. It’s hard to believe because it is logical to think that pain is being caused because of a torn muscle, an issue with a spinal joint or something else. Studies have found that MRI results do not reflect very well the cause of a persons pain. In fact many of the things we find on X ray and MRI that we used to think caused pain is pretty normal for most people as they are found in non pain patients. That is why it’s complex, because why do some people get chronic pain when others do not?
Chronic pain can be draining, zap the energy right out of you, it can cause anxiety, negative emotions and even depression. It can be argued also, that pain can cause depression or depression can cause physical pain. Treating the person as a whole in a supportive way and as a team gets the best outcomes. We have close contacts with CBT (Cognitive behavioural therapy) therapists in Cardiff to get the right treatments for patients when things are overwhelming or unmanageable.
Why does back pain come back?
Chiropractic is very effective for the short term relief of back pain. This gives us a window of opportunity to get the patient more active (movement based therapy), give them the coping strategies on how to deal with pain and plant the seeds of a little pain science. When patients follow the prescribed care that we both decide on using achievable goals then the results are longer lived. Often the issue is the pain goes away for someone, they stop the movement therapy, stop using coping strategies and the switch goes off again. Yes they now have a back up which is great but we also don’t want to create reliance on care.
What is the answer?
One word. Maintenance. Maintenance care has shown to manage chronic back pain quite successfully in many cases. Often it’s a lot less work for both parties to maintain low and manageable levels of pain. We can reinforce that the patient is doing the right exercises and coping strategies, we can also change things up if need be. If we do the same treatment all of the time the brain has a cunning knack of knowing what is coming next. Variety keeps the brain guessing and keeps those painful days, months and years at bay. It is more cost effective for the patient also as a monthly session is cheaper than 2-4 flair ups over a year. Maintenance also lowers pain medication that have side effects increasing energy and well being. It is important that the patient discusses medication with their GP as we are not qualified to tell the patient to stop their medication. I see my chiropractor in Cardiff regularly as I too get achy leaning over a treatment table for long periods of time. I have come to accept that it is a part of my job but also have the knowledge to not let it bother me and get on with life.
I really hope this has helped someone out there and feel like you are not on your own. This Cardiff chiropractor has your back 💪.
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