Mastering Lower Back Pain

Chronic back pain can feel scary, but are common beliefs about the spine being fragile, damaged, or unsafe supported by what we know about pain science? Watch the video to discover more!

Especially when it comes to chronic lower back pain: stress decreases our threshold for pain in the spine.

Some people will experience pain in their back even though there's nothing biomechanically wrong with it. That's because their stress has decreased their threshold for pain low enough for them to spontaneously feel pain in their lower back. Stress coping mechanisms are going to be key here to helping decrease the lower back pain.

Because people with chronic lower back pain can develop symptoms without any biomechanical issues, they can let go of the stress of constantly 'need to move to feel better in their back' or the idea that their back 'can't get any better'. Once beyond these beliefs, they can put more energy into finding out what's actually causing them stress and dealing with that.

Whether it be coping mechanisms with an imposed deadline or a relational crisis, a patient who realises that this is the cause of their decreased pain threshold just have to focus their willpower at coping with THAT situation. Doing so literally is dealing with their back problem. By taking care of the stressor they’ll raise their threshold and will likely not feel back pain anymore.

For many people, pain is multifactorial, so even if these beliefs influence pain to some degree, the information shared in the sub-acute and acute phase should help out too! Biomechanical reasons could still play a role: excess muscle tension, low joint hygiene, poor muscle control and lack of muscle strength. Find those videos in the Sub-Acute and Acute Back Pain sections. These factors could help more medium to long term.

If you have any questions, let me know in the youtube comments. I hope this is helpful :)

Reference for the first graphs:

Brinjikji, W., P. H. Luetmer, B. Comstock, B. W. Bresnahan, L. E. Chen, R. A. Deyo, S. Halabi, et al. “Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations.” AJNR. American Journal of Neuroradiology 36, no. 4 (April 2015): 811–16.  https://doi.org/10.3174/ajnr.A4173.

If that doesn't convince you, here's a 10-year longitudinal study that found that MRI scans don't predict lower back pain whatsoever:

Tonosu, Juichi, Hiroyuki Oka, Akiro Higashikawa, Hiroshi Okazaki, Sakae Tanaka, and Ko Matsudaira. “The Associations between Magnetic Resonance Imaging Findings and Low Back Pain: A 10-Year Longitudinal Analysis.” PloS One 12, no. 11 (2017): e0188057.  https://doi.org/10.1371/journal.pone.0188057.

That should be good news.

Here's the third reference (3) I mentioned in the video and another one for general information.

Kahere, Morris, and Themba Ginindza. “The Burden of Non-Specific Chronic Low Back Pain among Adults in KwaZulu-Natal, South Africa: A Protocol for a Mixed-Methods Study.” BMJ Open 10, no. 9 (September 1, 2020): e039554.  https://doi.org/10.1136/bmjopen-2020-039554.

Balagué, Federico, Anne F. Mannion, Ferran Pellisé, and Christine Cedraschi. “Non-Specific Low Back Pain.” The Lancet 379, no. 9814 (February 4, 2012): 482–91.  https://doi.org/10.1016/S0140-6736(11)60610-7.