Moving Beyond One-Size-Fits-All: Navigating Chronic Pains
For acute pain lasting under six weeks that is severe or limiting, short-term spinal manipulation or other passive care techniques might be beneficial. However, for chronic pain lasting over twelve weeks, passive treatments like chiropractic, medication, and massage become less effective.
Solely depending on professionals for chronic pain relief might not yield the best results in enhancing life quality or functionality. It is crucial to pursue active treatments for better symptom self-management.
This is because chronic pain is not solely related to physical disorders alone. While they may be a significant contributor, ongoing pain often ties back to a nervous system that grows more sensitive and hyper-protective over time.
Heightened sensitivity can distort our body's threat detection, amplifying benign sensations into intense danger alerts in the brain. In turn, distorted threat perceptions can trigger overprotective responses, prolonging symptoms and causing pain, even when the body is undamaged and objectively healthy.
Experiencing pain without physical harm can hinder our engagement in adaptive behaviours and meaningful activities, diminishing our overall quality of life.
Desensitising the Spine: A Pain Reframing Approach
Although science may not offer a solution for every type of pain, we can modify our own thoughts, beliefs, and behaviours to better cope with these challenges. In cases where individuals experience symptoms that persist or recur beyond the expected healing period, it is crucial to adopt a personalised self-management approach to effectively reduce long-term pain sensitivity.
Pain does not necessarily mean damage, and recognising that the spine is resilient and has likely healed as much as it can, despite any discomfort experienced, techniques such as cognitive behavioural therapy, relaxation exercises, and goal-setting can be utilised to reshape negative reactions to pain.
Individuals are encouraged to relax, flex, and load their spines, challenging unhelpful behaviours to discover new strategies and comfort levels that may be more effective for them.
With renewed spine confidence, individuals develop better stress-coping methods, tackle obstacles, and slowly return to valued activities, while minimising symptom triggers and avoiding excessive distress.
This enables a more physically fulfilling life, even amidst ongoing discomfort.
Harnessing Antifragility: Slow Cooking Resilience for Improved Coping
While immunity to pain might seem ideal in fiction, for those with congenital insensitivity to pain, it is a profound disadvantage. Unable to detect harm, they suffer unnoticed injuries and infections, with severe complications often leading to a shortened lifespan.
Nevertheless, many people believe that perfect health requires living without any pain. However, pain is an essential aspect of being alive. Accepting pain, while detaching ourselves emotionally from it, can liberate us from chasing a pain-free illusion.
When addressing low back pain, it is more apt to compare it to chronic conditions like diabetes or asthma, rather than quick-healing acute injuries like cuts. Like other chronic issues, managing back pain often involves continuous efforts to reduce its daily impact. This viewpoint aids in effectively handling its lasting symptoms.
Recurring mild to moderate flare-ups are typical and expected in this common and largely harmless condition, and they usually resolve on their own.
However, their complex and unpredictable nature makes their prevention an often insurmountable challenge.
Instead, like baldness or wrinkles, accepting back pain as a life norm can reduce self-blame.
Once symptoms ease, it creates a stronger foundation for training. Rather than fearing pain, by embracing antifragility, we strengthen our body and gain confidence to handle stress and intermittent pain, minimising its impact on our daily routines.
The Art of Adaptation: Balancing Workload to Match Life’s Demands
For low back pain, flare-ups can happen when someone suddenly increases their activity or tackles demanding tasks unprepared.
Tim Gabbett’s acute-to-chronic workload ratio compares the past week's activity to the month's average, helping assess capacity and injury risk.
For instance, activities like moving house or starting a new project can strain unaccustomed tissues, causing protective pain.
To manage this, it is beneficial to gradually increase activity intensity, allowing the body to adapt.
This approach prepares us for unexpected physical demands, reducing the risk of flare-ups.
Overprotective beliefs can lead to avoiding spinal activities, trapping individuals in a "rehab purgatory." Here, they recover from initial symptoms but remain woefully unprepared for daily physical challenges.
These outdated beliefs about resilience come from the idea that tissues bounce back to their original form after stress.
Like a rubber band that snaps back after stretching but wears out if overstretched. However, avoiding physical activity to protect our tissues can weaken our body, increasing vulnerability. This can result in a cycle of recurring injuries, further avoidance, and rapid physical decline.
Antifragility, a concept introduced by Nassim Taleb, goes beyond resilience by suggesting that systems can flourish under stress.
It means our tissues do not just bounce back; they grow stronger, highlighting our body's adaptability.
"Wear and tear" are better termed "wear and repair," as stressors stimulate tissue-strengthening adaptations that fortify our tissues.
This enhances our cardiovascular system’s efficiency, bolsters our bone and tissue density, and nurtures muscle growth, enabling us to thrive.
Embodying antifragility.
Leap of Faith: Conquering Fear with Graded Exposure
In the realm of addressing back pain and its effects, it is evident that there is a lack of a universally agreed upon "best approach." Different approaches exist, some of which emphasise the role of the brain in perceiving pain, essentially separating discomfort from the physical body. On the other hand, there are approaches that concentrate on the physical body, somewhat disregarding the neural and environmental aspects of pain. Certain methods prioritise protection to minimise distress, while others advocate for early exposure to promote adaptation.
However, in the midst of conflicting advice and opinions from experts, there is one universal constant: facilitating a gradual return to meaningful activities.
Ultimately, as confidence grows, we gradually challenge activities we previously avoided, learning to embrace life without anxiety or excessive caution.
