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Low back pain and the brain

It’s no lie that many of us have experienced an episode of low back pain at some point in our lives. Some episodes are more intense than others, whilst others are a lot more chronic. Individuals deal with pain differently, their perception of what the intensity is like differs on various factors. Emotional, mental, physical, cultural, and social aspects all influence someone’s perception of pain. It is important to understand that when an episode of low back pain arises, whether acute or chronic you MUST keep moving. Of course, when the intensity of the pain is so severe you feel really limited. However, there generally is some form of movement your physiotherapist will guide you to do. As your pain settles and you are back to your baseline pain – exercise progression should be the main focus. Targeting a global aspect not only the core. YES – the core does play a huge role in stabilizing the lumbo-pelvic girdle, however, there are other alternative routes that affect a patient’s progression in function.

Fear avoidance model

This is a model that illustrates a patient to have maladaptive behaviours / movement patterns due to the brain having a fear of pain / another episode of pain. This is extremely common when it comes to low back pain – particularly those with chronic issues. A lot of the time patients have been told they have “degenerative spines, collapsed discs, bone on bone” by a health professional at some point in their lives. These words with negative connotations attached to them definitely plays a role and influences how the patient perceives themselves and their pain! Outside of core training, attention to these maladaptive behaviours are crucial to restoring proper function in patients. Education, positive re-assurance is also key to ensure the patient has a more positive outlook to movement and their ideology on pain.

A great physiotherapist will not only look at the physical, but explore the mental, emotional and social aspects of your low back pain. As we are in a biopsychosocial model of low back pain, best outcomes are achieved when we approach it from a global point of view.

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