Pain is one complex topic! If you suffer from chronic pain you would know that there is no simple solution and hopefully through your journey you might have noticed that there are some things that can really increase and decrease your symptoms outside of the pathophysiology (see my stress and healing blog post and the sleep/pain cycle blog post).
In particular, communication plays a major role. That is, communication from your health care provider and communication to yourself. O’sullivan & Lin (2014) reported that negative beliefs are predictors of pain intensity, disability levels and chronicity. They report that negative emotions and beliefs can play a role in sensitising spinal structures via the central Nervous System. In other words thinking negatively about your situation can make things hurt more!
In the health care setting most of our beliefs of our physical issues come from health care providers who have given us advice and education around our issues. Have you ever stopped and thought about how your health care professional communicates with you? Is your health professional using words that generate fear, anxiety, despair and hopelessness?
Now don’t get me wrong; I am certain that your therapist has no calculated intention of instilling fear… but sometimes without thinking, analogies and phrases can come out of our mouths that inevitably create anxieties about the whole situation.
Let’s do an experiment, have a think about how you feel when you read these words:
“Your back is damaged”
“You have a back of a 70 year old”
“Your back is weak”
“You have to be careful” (Really, what could happen if I don’t?”)
“This will be here for the rest of your life” (Great! I am doomed, stuck with issues forever”)
“Your back wears out as you get older”
“Let pain guide you” (You mean pain is always bad and should be avoided?”)
For myself they produce fear and leave me with a feeling of hopelessness. When there is a feeling of hopelessness it is hard to feel motivated to do anything… from exercise, to daily self care and inevitably it can be difficult in becoming an active participant on your healing journey.
Now once you have seen your therapist and you get home and friends and family ask you “how’s your back going, what did they say?”. You naturally reflect back the beliefs and the communicated messages your therapist gave you. Resulting in an affirmation of the negative emotions and beliefs.
This leads me to my next question, have you taken the time to consider the words you are telling yourself? Words infused with optimism are healing! O’Sullivan and Lin (2014) reported that people who have positive beliefs are less disabled. Why? Because positive beliefs bolster your strengths and increase self reliance which means you may have better coping strategies and are more likely to exercise and move in a more natural way throughout your day.
Now have a think about what these words illicit in you:
“Back pain does not mean damage, it means it is sensitised”
“The brain acts as an amplifier, the more you worry and think about your pain the worse if gets”
“Your back is one of the strongest structures in the human body. It is very rare to do permanent damage to your back”
“Your scan changes are normal, like grey hair is”
“Movements may be painful at first but like an ankle sprain they will get better as you get active”
The language you use can lift your spirits, so next time your symptoms are high watch out for words that intensify any negative emotions and potentially destroy hope and remember words infused with optimism are healing!
O’Sullivan, P & Lin, P. (2014). Acute Low back pain beyond drug therapies. Pain Management today, 1(1):813.
Main, C. J., Foster, N., & Buchbinder, R. (2010). How important are back pain beliefs and expectations for satisfactory recovery from back pain? Best Practice & Research Clinical Rheumatology, 24(2), 205–217. doi:10.1016/j.berh.2009.12.012