Right off the bat, the idea of managing your own pain sounds WAY too daunting. I get it. With learning comes more knowledge, more knowledge helps us make better decisions. Too many decisions leads us to completely shut down. So let’s make this simple.
Persistent pain, particularly lower back pain, affects millions of individuals worldwide. Traditional approaches to pain management often involve medical interventions, medications that may not help (though some do), physical therapy, and appointment after appointment. Blah, blah, you’ve likely heard me talk about this already. However, recent research suggests that self-management plays a pivotal role in addressing persistent pain. Let’s look at the why, and then with the help of a few stories, we’ll look at how you can take the first step forward to building your path back to wellness.
The Self-Management Must Haves
Self-management refers to the active involvement of the patient (you) in the treatment process, allowing you to be heard and become a key decision maker in your care. A key factor in this self management plan is education. So, if you are at a place in your life where you are done with learning anything new, you’ve already heard everything there is, and you are not interested… all the best to you, sincerely. However, if you are willing to open your mind, follow the current science, and find the energy to engage in the conversation, then let’s keep reading!
First! Education and Understanding. Knowledge is a powerful tool, and when individuals are equipped with a basic understanding of their condition, they are better prepared to manage it. In the case of lower back pain, understanding the basic anatomy & biomechanics of the spine and the role the nervous system plays in creating pain sensations can be very helpful.
Programs that teach patients about the nature of persistent pain, its potential causes, and evidence-based strategies for managing it have shown significant promise. These programs often include information on the importance of movement & getting active, the basics of movement anatomy, ideas for living a healthy lifestyle, and practicing strategies that will be there when the pain flares up. By providing you with the knowledge to interpret and manage your symptoms, education proves to be a key factor of self-management.
Next part to look at is engaging in regular physical activity. No, I’m not going to use the word exercise. Ideally you will be building movement into your day, creating a sustainable level of activity that you can build on if you have the energy, or easily maintain when your motivation drops. One thing we do know... resting and waiting until your back pain disappears is not realistic or good advice.
This is where movement snacks come in. Let’s add in small, achievable movements that you can build into your daily routine. My favourite is squats. We all brush our teeth (at least I hope you do) and while we are standing there, staring at ourselves in the mirror, why not add in a little movement. Start with bending your knees and sitting back 3 inches. Done. Do it again. Does it feel ok? Maybe try for 4 inches. Do you have an electric toothbrush? That is an excellent 2 min timer.
Build this into more movement snacks… find a doorway that you can reach up into and feel a bit of a stretch in your upper body. Heads up, we are looking for a whisper stretch, not a screaming stretch. Maybe add in some wall push ups. Drive through the day? Each time you get in your car, create a mindful rotation to reach and put on your seatbelt. Then rotate the other way as well. Take 3 breaths, make it a habit.
Feeling more energy after a couple of weeks? Let’s build it into a 10 min movement circuit. One small step after the other.
Last but certainly not to be overlooked. Our mind. Self management strategies need to address how we think about our pain (education helps!) and how our emotions and feelings affect us (certainly more coming on this topic later!). This is where the mind-body connection comes into practice. We need to practice the tools we’ll use when our pain sensations get the best of us, and then ideally, we’ll have built the awareness to notice the whispers that happen before the blow up occurs. You will also learn that finding patience with yourself will help you not only maintain your program but keep you motivated to learn more and build your self efficacy.
PRT (Pain Reprocessing Therapy), for example, helps individuals identify and change negative thought patterns related to pain, promoting healthier coping mechanisms. This mindfulness technique, including meditation and deep breathing exercises, can foster a heightened awareness of the present moment, reducing stress and anxiety associated with persistent pain.
4 Real-life Examples of Effective Self-Management
Mindfulness Meditation for Lower Back Pain
Sarah, a 45-year-old office worker, struggled with chronic lower back pain exacerbated by long hours of desk work. Frustrated with the limited relief provided by medications, she explored mindfulness meditation as a self-management strategy. Through regular mindfulness practice, Sarah learned to observe her pain without judgment, reducing the emotional impact it had on her daily life. Over time, she reported decreased pain intensity and improved ability to engage in work and recreational activities.
Exercise Rehabilitation for Lumbar Disc Herniation
John, a 35-year-old fitness enthusiast, faced persistent lower back pain due to a lumbar disc herniation. Instead of opting for surgery immediately, he worked with a Kinesiologist to develop a personalized fitness program. This included movements that would build his body awareness around holding tension and building strength & mobility so that he could return to his loved recreational activities with confidence! The Kinesiologist supported his progress weekly and every few weeks met with him to keep him on target for his goals. Through consistent adherence to his fitness routine, John not only avoided surgery but also experienced a significant reduction in pain. He returned to the ski hill that winter with more confidence and balance! Look out moguls!
Pain Reprocessing Therapy for Chronic Back Pain
Emily, a 50-year-old with a history of chronic back pain, found herself caught in a cycle of negative thoughts, fear-avoidance behaviours, and kinesiophobia (fear of moving her body the wrong way). Seeking a holistic approach, she began pain reprocessing therapy sessions. By addressing her negative beliefs about pain and connecting the sensations in her back to a safer, calm reaction in her mind, Emily developed healthier coping mechanisms. Over time, she reported a noticeable decrease in pain-related anxiety and an improved ability to engage in daily activities without the fear of exacerbating her pain.
Self-Directed Education and Lifestyle Changes
Mark, a 55-year-old office executive, struggled with persistent lower back pain aggravated by prolonged periods of sitting and getting caught up with work. Taking the initiative, he embarked on a journey of self-directed education. Mark learned that it isn’t really about all the sitting, it was about not listening when his body was uncomfortable. Overriding this initial uncomfortable sensation of sitting still too long, his nervous system had created a response that now felt like sharp, stabbing pain which would finally get him to move! He adopted a strategy for adding more movement into his day and created a schedule for short movement snacks at work. Through these self-management efforts, Mark experienced a gradual reduction in lower back pain and a newfound sense of control over his well-being.
I want to close this post by pointing out that this is not saying that you are on your own in this journey. Yes, you are responsible for the work that you do, the path that you find most meaningful to you, and the vision of where you see a healthy lifestyle that you can sustain. Don’t make this a big jump. Imagine a staircase, a long one that will help you take one step at a time. Yes, the first few steps are steeper than the last. Sometimes you’ll take too many steps at once and you’ll need to step back. At some point, if you continue on your staircase, you’ll find that the steps are easier, not steep at all. You may even soar!