Back pain

Last Sunday, three St. Louis area massage therapists met to watch a video recording of Peter O'Sullivan's keynote address at the 2017 San Diego Pain Summit. The subject of O'Sullivan's address was A Paradigm Shift in Understanding and Managing Low Back Pain.

My friend recently died of breast cancer. She was an amazing woman who lived fully until the end. Everyone who knew her loved her, she made everyone feel special. I hadn't known her all that long or even that well but she had an impact on my life out of proportion to our time spent together. When her cancer recurred, I wanted to do whatever I could to help. One of the things I was able to offer was massage.

Our first massage was a general full body relaxation massage. She loved it. She had been having trouble sleeping and it left her feeling so relaxed that she felt as if she could fall asleep. I told her I would come and give her massage whenever she wanted. She stayed pretty busy in spite of the illness and so several weeks passed before I gave her massage again.

The labeling of nociceptors as pain fibers was not an admirable simplification, but an unfortunate trivialization under the guise of simplification. 

From Patrick Wall, eminent pain scientist and author of the gate theory of pain.

Clients never mention it, but occasionally in more personal conversations someone will bring it up: chronic pain can interfere with intimate relationships.

Most clients would not mention it to their massage therapist and it is not within our scope of practice to treat. However, since February is the month of Valentine's Day, I thought it would be an appropriate time to bring up a pain topic that may hurt your love, is rarely discussed, that many massage therapists may not know exists, and that many people may suffer with silently without seeking help or getting proper treatment.

Common chronic pain problems can hurt your love.

Chronic low back pain and chronic headaches are two common pain problems that can interfere in intimate relationships. It's hard to feel romantic when your head hurts and low back pain may make physical intimacy difficult. When chronic pain interferes with your love life, it can erode the closeness of your relationship. This is just one of many reasons why chronic pain should be treated and not just assumed to be an inevitable part of life. The deterioration of the quality of one's life can be far-reaching.

These are notes from a presentation given at the Skeptical Society of St. Louis Skepticamp on Saturday, September 14, 2013. Links to some of the resources and studies mentioned during the presentation, as well as additional links that may be of interest, are provided for those who would like to look at them.

A Skeptical Look at Back Pain: Notes from Skepticamp 2013

In 1995 I was working at St. Mary’s hospital when I heard about this study which examined 98 people who had no low back pain (LBP) and found that a large percentage had herniated discs. ("asymptomatic" means without symptoms i.e. no pain)

 http://www.nejm.org/doi/full/10.1056/NEJM199407143310201

            98 asymptomatic individuals ages 20 – 80

            36% normal discs at all levels

            52% bulging disc at at least 1 level

            38% abnormal at more than one level

            Findings similar in men & women

            Abnormalities increased with age

"Did you hear about the study of the MRIs and herniated discs?" It was 1995, I was working at St. Mary's Hospital, and one of my fellow massage therapists had news about a surprising piece of research. In those days before the internet it was difficult for us to get information about studies of interest to us massage therapists. A juicy tidbit like this was cause for excitement.

If I could make only one recommendation to individuals living with chronic pain, it would be to read the book Explain Pain by David Butler and Lorimer Moseley.

Directed at both clinicians who work with chronic pain patients and patients who live with chronic pain, Explain Pain shows how the discoveries of modern pain science can be put to practical use. Written in understandable language with a touch of lighthearted humor, Butler and Moseley take a complex subject and make it possible for the average person to understand and use. One client remarked that she thought it would be hard to read and was delighted that she did not find it difficult at all. 

Graded exposure can be a useful technique for persons living with chronic pain. Graded exposure is a method of finding movement that is pain-free and building on that. The idea is to break the brain's association between a particular movement and pain.

Got back pain? Call us!

Low back pain is one of the leading causes of disability in the United States. Everyone knows someone who suffers from back pain and most Americans will suffer from it some time in their life.  In spite of its prevalence, successful treatment of low back pain remains elusive. No one has consistently good statistics in the treatment of low back pain.

What can we offer you?

We cannot promise results. However, we can promise this: