Do you fear that doing exercises will make your damaged spine even worse?
What is she saying NOW? I have been told I have damage to my spine. It hurts; I can’t possibly exercise or walk or move far without making things worse – she just doesn’t understand!!
She DOES but you must all also understand that long lasting i.e. persistent or chronic pain does NOT provide accurate information about the state of the tissues that are hurting! The longer the pain goes on for, the relationship between the pain you are feeling and the state of the tissues in your body becomes even less clear.
Acute v Chronic
I’m not talking here about damaging something like breaking a bone or some other acute injury – that is an acute pain that needs action. It is very different to persistent or recurrent, non-specific low back or neck pain. Acute pain is what you feel when you do break a bone or stand on a drawing pin or twist awkwardly. It hurts and needs you to get it fixed appropriate to the injury.
I’m talking about those who have persistent pain that stops them helping themselves because of fear of the further damage that they are going to do. Chronic, recurrent, mind altering, depressing, tiring, relentless pain that can sometimes take over your whole life. “There must be something wrong, I feel so much pain”. We often hear these words from patients who have had scans and x-rays and all sorts of tests but there is nothing to ‘see’ or from patients who have been told that they have degeneration or disc damage etc.
So What Causes The Pain?
Pain is more likely to be related to the person’s perceived threat to the body’s tissues than to tissue damage. So if you think that what you have been told about your body is going to be a big deal and painful – then it will be!
I spoke last week about the words that we hear and how we interpret them.
“You have disc degeneration”
- To a chiropractor means “You may have injured that disc some time in the past or it might just be due to the fact that you getting older and it has gradually worn as things do! We can deduce this as the disc space between vertebrae is now showing as a thinner than it should be on x-ray along with bony outgrowths (osteophytes) and thickening of bone on the edges”.
- To a patient it could mean anything for example ‘Injury? … so he is saying I have damaged something in my spine. Damage equals pain that won’t get better. I am in pain now because of it and I so I always will be’.
Or ‘Disc? What does a disc do? I’ve heard of a slipped disc – they last for ever – a friend had one and he never got better, have I got that too?’
Or ‘Osteophytes? (bone spurs) What are they? Growth of bone – what’s that? A growth can be serious…..do I have a growth that is causing my pain? Should I be worried?’
All of these interpretations by patients are very good at causing anxiety and fear and fire your imagination that if you exercise you are going to make it all so much worse because you have a mental picture of your discs being in a “state of collapse”
What is really happening
As we get older, our skin wrinkles and is less resilient.
Discs separate each vertebra in your spine and are made of the same material (collagen) as your skin so they are going to become ‘wrinkly’ and less resilient in a similar way.
Therefore, on x-ray or scan instead of seeing a big space between each vertebra, there is a much thinner space.
Think about it; as you age, your face doesn’t hurt – it just looks different to when you were 30 – so why would you expect your discs to hurt just because they look different too?
If you sprain your ankle, it heals. You don’t feel pain all your life as a consequence. If you tear a disc it heals too and in the same way you should not feel pain in it years later!
So why do you feel pain?
Fear and anxiety and lack of exercise are all powerful at causing you to feel pain.
You need to understand that it is not due to tissue damage and you aren’t ‘fragile’ and you don’t need to be ‘cautious’ or ‘never lift again’ or ‘move very carefully’.
If you don’t fully understand what we are saying to you, ask for a better explanation! Just because we know what is wrong and you don’t, it is not you ‘being stupid’ it is us not explaining things properly so that you DO understand!
If you would like us to show you pictures of what has happened – ask. If you are happier with a verbal explanation – ask – we are here to help.
We generally often misinterpret or forget a lot of what we are told. Particularly when we are in an unfamiliar environment and hearing a lot of unfamiliar words.
The thing to remember is that research has shown that the more you understand your condition the better able you are to cope and you feel less pain and use less painkillers, so please don’t ever feel that you can’t ask anyone to clarify anything that you don’t understand!
It is our role not only to try to alleviate your pain but also to educate you. We don’t want to overload you with too much science but we also will never be dismissive of your problem just because we don’t think it is a big deal. We just need to convince you that you really are stronger than you think and those good old exercises WILL help you rather than make things worse!