Low Back Pain and Chronic Pain

About 85% of low back pain is what’s known as acute low back pain. It is largely temporary, resolves on its own within 12 weeks and is park of a normal overall pain warning system with or without actual tissue damage. (Yes that’s right, there isn’t always something structurally wrong or damaged for there to be pain, the body doesn’t always get the warning system perfectly right.)

The other 15% of low back pain becomes what we call chronic pain, which is classified as pain over 3 months. About 8 million Canadians suffer from chronic pain, or 1 in 4 over the age of 15. And about 1 in 4 of those people go on to develop chronic pain syndrome, where it starts to take a heavier toll on their psychosocial state and functioning in daily life. In other words, low back pain has varying levels of severity and disability associated with it as well as varying factors that stem from biological, psychological and social causes.

So how will an RMT like me begin to tackle such a complex problem such as low back pain? Well, I can’t do it all, but I can do what’s in my scope. Helping to control pain levels and increase range of motion with a combination of passive treatment options such as your typical Swedish massage techniques and some other manual techniques such as cupping and fascial techniques. As well as a generous understanding of the literature around active techniques, both movement and resistance based exercises, to help increase confidence in movement, ability to control one’s own pain, natural endorphins.

Creating an exercise plan around an injury or around chronic pain might look like

• Finding what makes your pain go away

• Avoid painful movement in short term

• Build capacity in long term

• Retraining the painful movement

• Using active techniques to increase self efficacy - your own pain control

Something even as simple as walking makes an excellent endurance exercise. My aim is to work together as a team, creating your own goals, and using me as a coach to assist and reassure you through the process.

Ultimately, some pain is too complex to be treated by just one person. I can still be part of your circle of care, working together with your doctor, psychological services or other health care providers. Chronic pain is multifaceted. There are many treatment options. A full care team could be a physician, a naturopath, a psychologist, chiropractor, physiotherapist, occupational therapist and the list goes on.

Chronic pain can also have a huge psychological component, and there is no shame in getting the care you deserve for it. My psychological aid would stay within my scope, focusing on the movement based stuff such as over reliance on passive care, expecting poor treatment outcome from manual care, avoiding activities expecting injury, various other worries, fears and anxieties associated with movement and soft tissues of the body.

Working on such a team is where I came from and would ultimately like to find again in this new city of Sudbury I live in. For now, I still want to offer my services as an excellent RMT with a passion for pain care.

Malfliet A, Ickmans K, Huysmans E, Coppieters I, Willaert W, Van Bogaert W, Rheel E, Bilterys T, Van Wilgen P, Nijs J. Best Evidence Rehabilitation for Chronic Pain Part 3: Low Back Pain. Journal of Clinical Medicine. 2019; 8(7):1063. https://doi.org/10.3390/jcm8071063

Vanti C, Andreatta S, Borghi S, Guccione AA, Pillastrini P & Bertozzi L. (2019) The effectiveness of walking versus exercise on pain and function in chronic low back pain: a systematic review and meta-analysis of randomized trials, Disability and Rehabilitation, 41:6, 622-632, DOI: 10.1080/09638288.2017.1410730