Lower Back Pain Management

 

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The lower back: The pain with lower back trouble
To say we have pain is pretty simplistic and does not really help us much. The pain system is complex, and just to say have pain does not really help us work out what to do next.
 

Throughout this series of articles I will explore the common causes of lower back pain, debunk the many myths and misconceptions about back trouble and give some guidance on how to better manage your back pain. In this first article I discuss pain in general terms, before we get to the nitty gritty of what to do about it.

First of all, what are we really dealing with here? Back trouble is really common. If you are standing in an elevator with nine others, two of you will complain of back pain right now and at least eight of you will have some back pain that temporarily puts them out of action at some point of there lives. Pain is the most common reason for seeking medical help, with back pain being the most common musculoskeletal complaint.

We all use the word pain, but what is pain? “Pain” is a collective term for the unpleasant feeling that we experience with actual or potential tissue damage. The system is activated when you are either in trouble OR your body believes it’s in trouble.

There are three regions the pain system. The “generation areas” pick up information, the nervous system relays this to the central nervous system and the brain decides what to do next. Various regions of the brain are involved and are really powerful in determining what’s it’s going to pay attention to. There is a strong off switch until something happens out of the ordinary.

All tissues in the body are sensitive to mechanical strain, tissue damage or inflammation. In the presence of excessive strain the “danger” signal is relayed to the spinal cord and then up the brain so something can be done about it.

The nervous system relays this danger signal to the brain. There is a quick signal to the brain saying “pay attention to what coming” and a slow signal saying “yes, there is danger here”.

Brain has considered and decided if the “danger” is really dangerous based on the all the information it can gather. For example I’ve roller my ankle, but I can play on or I’ve hurt my back and can’t lift this box any more.

The amount of pain was have is determined more by what situation the body is in and past experiences, and less by how much damage is done. We have all seen the small child scratch a knee and wonder what to do next. Pain in the true sense is a bit like an emotion telling our conscious self that maybe something not is right.

Consider pain a bit like Foxtel. There is digital information coming in all the time (danger signals) relayed by the cable lines (relay system) and put back into a picture with sound by the cable box (perception area). If there is no picture, you don’t’ immediately know if the TV is broken, the cable box is giving you some faulty information or the actual cable is at fault. Up until that point you are not really worried how it works, you just want to keep up to date with the footy score.

To demonstrate, hold your finger and pull it gently back towards you. Danger signals are being generated (from the excessive stretch) and you will be immediately aware that your finger does not feel right. This is because the relay (nervous) system has sent signal to your “pain centers” of the brain and made you aware that your finger is in trouble. Now bite your tongue (not too hard) tongue hurts, but your finger does not! You can’t watch two channels at once.

We can see that a diagnosis that says we have “pain” in our back is not really that helpful after all. It’s better to identify the causative factors and deal with these.

In my next article I’ll talk about how various types of back pain can develop and discuss how we go about working it all out.

Article contributed by: Bruce Gilmore

Brighton Spinal Group
441 Bay Street
BRIGHTON VIC 3186
ph. 9596 7211 fax: 9596 7871
www.brightonspinal.com.au
 

 

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