There's quite a few reasons, here are the most common ones:
- Returning to an activity too soon after an acute injury
An acute flare-up usually takes 2 to 3 weeks to resolve fully and we advise our patients to rest or modify their activity until then. However, sometimes they feel so much better and think that they are ready before their bodies actually are.
- Bad posture, desk or repetitive work
For many of us, work is sedentary and the human body is just not made for sitting all day! We sit in front of a computer, sit in our car to get home, then sit on the couch to relax. And do it again tomorrow. No wonder we get sore necks and backs after a few weeks. As for posture, you have two types of muscle fibres, fast twitch and slow twitch. Slow twitch fibres are postural muscles like your core, which are designed to keep you upright with minimal effort. Fast twitch fibres are your big mover muscles like the hamstrings or the trapezius, which are designed to move your limbs quickly and powerfully. If you use fast twitch muscles to do the work of your postural muscles, they tire quickly and ache, which is what we find in patients with poor posture.
Stress changes the way we stand and move. Imagine facing off a tiger just a metre away, you can feel your shoulders clenching, your legs getting ready to run away. Now imagine the same tiger but behind a glass wall. Feel your muscles relax? Stress also affects the way our bodies compensate after injury. No one is perfectly symmetrical, pain happens when the body is no longer able to compensate.
- Chronic or progressive conditions
In some cases, the body is never going to return to its pre-injury state. For example, some forms of arthritis, disc injury, joint replacement surgery. Often, these patients have to work harder to be pain free, be more careful about how they move and remember to do regular exercises/stretches. Osteopathic treatment is aimed at maintaining their level of function or slowing down their disease progression.
- Increased nerve sensitisation
In chronic pain, the nerves start to behave differently in that they respond to lower and lower levels of stimulation, such that they go straight to alarm mode even with normal stimulus. According to Professor Lorimer Moseley, speaking at TedXAdelaide: "Pain is an output of the brain designed to protect you. Pain isn't actually coming from the tissues in the body." If you don't believe this, check out the experiments done with an artificial limb. The more neurons run pain, the better they get at it, so a smaller number of neurons can produce the same level of pain. The networks also become less specific, so the pain spreads, becoming unhelpful and uninformative. Prof Mosley, a clinical and research neuroscientist at the University of South Australia, added that chronic pain can be reduced by training the brain to better recognise, imagine and move the affected limb.
- Other reasons
Pain can be merely physical, or it can have a deeper emotional or spiritual component. It can have its roots in a old strain from a trauma/fall that did not get addressed at the time. Often, the start of the healing is accepting that there are other reasons for the physical pain to persist.
We've always had the message drummed in to us to take Panadol or paracetamol when in pain but this article (login required) suggests it may not be as effective as we think, as least for lower back pain.
Between 2008 and 2013, 1643 adult patients (mean age: 45 years, 53% male) in Sydney, Australia, were placed in a study to look at the effectiveness of paracetamol with acute low back pain. They were divided into 3 groups: One was told to follow the stated dose, the second group to take the tablets as needed and the third group had the same instructions as the first group but were given placebo tablets.
There was no difference in pain or recovery time between the three groups and the median time to recovery for all of them was 17 days.
A much better way to manage acute lower back pain, as many of you know, is to give us a call and get a treatment - whether it be osteopathy, massage or naturopathy! We'll also be able to advise you on appropriate stretches and exercises for a faster recovery. When it comes to tablets, we're strong believers in using tumeric as a natural anti-inflammatory, which is nice and gentle for your gut. Speak to reception for for information.
All entries complied by osteopath Dr Wei Chua unless otherwise stated.