- Dr. Max Pemberton said that physical health problems have a psychological element.
- Our brain plays an important role in how we experience chronic pain, he said.
- People with chronic pain are often offered psychotherapy instead of painkillers.
- He also recommends progressive muscle relaxation to help with lower back pain.
Many physical health problems have a psychological component, and this is especially true for pain.
We know from countless studies that our brain plays an extraordinarily important role in experiencing chronic pain associated with low back problems.
People with chronic pain who are lucky enough to see a specialist are often surprised to find that they are being offered psychotherapy rather than just more pain-relieving drugs.
There is good research supporting this. Just last week a study was published showing that a four-week course of psychological therapy can dramatically reduce chronic back pain for at least a year for many patients.
People with chronic pain are often surprised to find that they are being offered psychotherapy rather than just more pain-relieving drugs, says Dr. Max Pemberton (pictured).
We know about a psychological component in our experience of pain for nearly 80 years.
During World War II, an American anesthetist named Henry Beecher was treating soldiers who had been seriously injured in combat—many having their legs amputated or shrapnel across their bodies—when he noticed that more than half reported little or no pain and did not request analgesia.
Beecher was surprised that in peacetime, nearly all of his patients requested painkillers for less severe injuries. Then he realized he had not accounted for one thing: the power of the mind.
He realized that, for the soldiers, a serious injury was really good – it meant that they would be discharged from the army and could return home. For citizens, however, it was bad – a disruption in their lives and routines that could mean financial hardship.
Beecher realized that it is not necessarily the magnitude of the injury that predicts how a person experiences pain, but rather the circumstances in which it occurs.
Since then we have come to understand more and more about the mind and pain and as a result, we have developed psychological therapies to help people with chronic pain.
I know from personal experience that back pain can be incredibly debilitating, as both my parents and I have dealt with it for years. When pain limits your physical activity, it affects your mood and this in turn makes the pain worse.
Other factors, such as your coping strategies and general outlook on life, also play a role. If you have a tendency to feel anxious or hopeless or overwhelmed, feeling pain will increase these feelings, and this can make the pain worse.
We know from countless studies that our brain plays an extraordinarily important role in experiencing chronic pain associated with low back problems (stock image).
However, it’s important to emphasize that, while our brains play a role in how we experience pain, you shouldn’t downplay it – chronic pain is very disabling.
While last week’s study involved a full, intensive four-week course, there are still some simple things everyone with back pain can do to address symptoms:
- Just don’t lie there. Years ago, doctors recommended bed rest for back pain. Now we know it doesn’t help – get up and do as much exercise as you can tolerate. Even if it is only walking to the shops. It helps in building muscle and preventing joint freezing. Exercise also helps to release endorphins which boost our mood and relaxes us. If in doubt, ask your doctor to refer you to a physiotherapist who can assess you and give you safe exercises to do at home.
- Try progressive muscle relaxation. Depending on the exact cause, this can be helpful. It is a technique by which a person reduces the level of anxiety by focusing on the parts of their body that are tense and consciously relaxing them. There are lots of free resources on the Internet to help guide you through the process.
- Try mindfulness. This involves focusing on the here and now to reduce stress levels. There are some great apps, such as Headspace, that offer guides.
- Take a breath Find a quiet place, sit down and breathe in for three seconds, hold for three seconds, then exhale for three seconds. Do this continuously for five minutes and while doing it pay attention to the air moving in and out of your lungs.
- reach out to friends. Back pain can be isolated as it can affect your normal day-to-day activities. Human interactions and relationships are inherently mood-boosting and stress-reducing. Schedule a daily phone call or coffee with a friend – even if it’s only for 15 minutes.
- hug someone. Physical contact activates the parasympathetic nervous system, which helps reduce the stress response triggered by chronic pain.
- get a pet. They provide a distraction, a sense of purpose and encourage you to get up—especially with dogs—out of the house. Alternatively, try borrowing one or inquire about pets as a form of therapy. Simply stroking a pet can relieve pain.
- Beware of ‘destructive’. We all have a tendency to see the sad side when we are in pain. We imagine the worst. But it can make the pain worse, so try to keep an eye on yourself for this kind of thinking and challenge it. Cognitive behavioral therapy can help with this.
- Try not to make predictions. Psychologists call this a ‘fortune-telling’, and it is common with chronic pain. Worrying about pain triggers feelings of fear that it will never end. Try to recognize this and remind yourself that you don’t know what will happen in the future.
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