Physiotherapist explains why back pain is often made worse

Physiotherapist explains why back pain is often made worse
Photo: CC0 Public Domain / unsplash – Sasun Bughdaryan

Back pain is a tiresome topic for many people. However, some people don’t realize that they are actually making their own pain worse by behaving in certain ways, says a physiotherapist.

According to the Robert Koch Institute, around 15 percent of Germans suffer from chronic back pain. However, sufferers are often not even aware that certain behavioral patterns make back pain worse. Professor Hannu Luomajoki from the Zurich University of Applied Sciences explains in an interview with Der Spiegel why and how back pain is often made worse.

Problems in diagnosing back pain

If you have back pain, you want to find out the cause of your pain as quickly as possible. Professor Luomajoki explains that an MRI scan can show an abnormality in the body – for example a bulging disc, degeneration of the spine or arthrosis. However, the physiotherapist points out that these deviations usually do not explain the pain, since these developments occur in almost all adults. However, some patients would then make the connection that they have something bad, since something can be seen on the MRI image. “In 98 percent of cases, it is only a matter of time before relief occurs,” says the doctor.

Fear Avoidance – avoiding movement for fear of aggravation

When patients think they have something bad, they often assume that exercise will only make the pain worse, Luomajoki explains. This creates fear of even more pain and this results in the avoidance of movement, also called “fear avoidance” in research, according to the expert in the Spiegel interview. “Fear avoidance” can lead to a negative spiral, because the pain can even be aggravated by a lack of movement, according to the expert.

The aggravation occurs in particular due to the breakdown of muscles and condition. The physiotherapist notes that this can turn harmless back pain into a chronic condition.

Keep exercising despite the pain

But the other side of the extreme, the so-called perseverance, also occurs in patients with back pain. These patients continue to exercise despite the pain because they tell themselves they have to endure the pain, says Luomajoki. This pattern of behavior is just as unhelpful for recovery, however, since one should not go beyond one’s pain threshold in the event of symptoms, he says.

“Passive behavior is unfavorable” – lying down too much when in pain

Avoiding exercise can be fatal for many patients. “Passive behavior is unfavourable,” warns Luomajoki in an interview with Spiegel. In the case of lumbago, for example, says the expert, only one or two days of bed rest are necessary. Being able to move easily despite the pain is important for recovery, says the physiotherapist. Stretching your back or bending your legs while lying down relieves pain in many patients. He recommends finding out for yourself what is good for you.

Better gels instead of painkillers

According to the physiotherapist, studies show that it is not relevant to the recovery time whether patients take placebo or ibuprofen. Pain gels, on the other hand, which are applied directly to the area, promise faster relief, according to him. Because the active ingredients get directly to the painful area and can therefore act faster and more specifically.

According to the professor, people who are in pain without experiencing numbness or paralysis can wait a few days before seeking medical advice. The acute pain usually disappears after one to two weeks. It is also important to understand that pain is not always the same, but sometimes stronger or weaker, according to the doctor. If the pain lasts longer than one to two weeks, the professor recommends going to the doctor.

Country differences in the treatment of back pain

The physiotherapist also points out country differences in the treatment of back pain. In Germany, patients without a doctor’s prescription have to pay for the physiotherapeutic treatment themselves. As soon as doctors issue a prescription, the health insurance covers most of the costs.

In Finland, for example, the treatment is the other way around. Patients first go to physiotherapy and get advice or exercises shown. If a serious problem is identified during the consultation, you will be referred to doctors. This strategy is very successful, Luomajoki explains to Der Spiegel, because “90 percent of the patients do not need medical help, but rather learn which exercises they can use to relieve their back pain.” The spiral of “fear avoidance” does not even happen set in motion, according to the expert.

Back pain is part of life

Luomajoki encourages his patients with an unusual comparison. Because he compares back pain with a cold, since both phenomena would come and go. He wants to make it clear to his patients that back pain is just as much a part of life as a cold.

Sources used: mirror

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