Picking the scab

People with chronic low-back pain are often looking high and low for “cures” or remedies in order to rid themselves of symptoms.

Finding short-term relief often comes in many different forms, but long-term success can be a mystery.

Unfortunately, practitioners who treat low-back pain are often excellent at the treatment portion but are less effective at helping create strategies to avoid painful movements and positions or find positions of relief. Without these strategies patients with low-back problems are often reaggravating the injury and delaying the healing process between treatments.

The secret to long-term success when managing low-back pain lies in the ability to move in ways that do not “pick the scab”.

We must think of a healing low-back as we would a scab; if we constantly pick a scab, it will not heal. The same can be said for the low-back; if we constantly move in ways that cause pain our back is telling us that it is not able to heal. What really matters to the patient is, how do you know if you are picking your low-back scab? Luckily your body has been telling you the answers!

The biggest clues involve what you are doing when your low-back hurts. Think back or observe over a few days when you feel pain or increased pain. Was it after a long day of bending forwards or does pain increase when rolling over in bed or transitioning from sit to stand? After collecting some information, look at the positions that are on your list. Is there a pattern? Does your back not like bending forwards, or reaching backwards? Does it not tolerate carrying heavy loads?

If you notice a pattern you now know what you need to avoid in order to properly let your back heal. This may require rethinking how you move during your day-to-day activities. You might have to learn to use your core as a brace in order to properly stabilize the low back when transitioning positions. Or, you might have to learn to use the hip joint to bend forward and keep the spine in a neutral position when picking things up off the floor. You might also have to learn to keep the head from bending forwards, especially for extended periods, as this causes increased activity and tension in the low-back musculature.

While this article should not be interpreted to belittle the role of the practitioner, it should highlight the fact that you can help yourself and that how you move is an integral part of low-back symptom management. Learn to move well, then move often (not the other way around) and be sure to talk to your practitioner about creating strategies that help you avoid picking that scab! 

Blog by Dr. Luc Mahler