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June 2017

Volume 7

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3: The Cycle

In order to explain a version of the chronic pain cycle, I am going by start talking about how helpful, friends and family are when their loved ones are having difficulties. In struggling with my ongoing lower back pain, I noticed how friends and family around me empathised and wanted to help in any way they could.

However, how do you tell your loved ones, that by helping you, they are not actually helping you get any better? -Huh? How does that make sense? Now this doesn’t apply to everything but, I will share with you my personal experience and I am sure anyone who has experienced chronic pain can also relate.

I’ll give you an example. I occasionally helped my mum carry the shopping from the boot of the car to inside the house. A relatively easy task. However, once my mum knew I was having ongoing back pain, she would insist on carrying the one semi-heavy box full of fruit and vegetables and leave me carrying a cartoon of eggs. This is just one example, however if this principle is applied to a number of activities across the day in order to “PROTECT” the back, this results in an overall reduction in physical activities. Continuing this for a period of time has two outcomes.

1: Physically, the body becomes deconditioned, losing muscular strength from doing less and resulting in the body having a lower load tolerance.

2: If someone is saying, “you CAN’T lift that” over and over, then it will rub off on your personal beliefs of your own abilities. This ultimately results in you too believing you CAN’T, causing you to physically not be able to complete the task anymore.

These outcomes feed in the chronic pain cycle. Your back hurts >>>>> you avoid loading activities to protect your back >>>>> resulting in increased levels of inactivity >>>>> you become more deconditioned >>>>> your pain gets worse >>>>> you do even less and round you go again.

When my lower back pain was at its worse and I stopped all the sport I was playing, I also ensured I wasn’t doing any movement which may have resulted in a back injury. For example vacuuming, making my bed, carrying heavier shopping bags and I avoided bending where possible, all to PROTECT my back. With all of this preventative action, my back did not get any better, surprise, surprise. So now my next question is, how do you keep doing activities and tasks which involve bending, lifting or anything that makes you think twice, due to visions of getting a back injury?

Now, the below advice is only relevant for chronic pain where there is no acute physical injury, with pain present for > 3 months.

In my experience, not once did I re-do a back injury from doing daily tasks around the house involving movements of bending, lifting and twisting. The only time I did re injure my back was when I wasn’t concentrating, moving too quickly or doing something silly. If there is a task which you would normally complete, however feel worried about re injuring your back, think, I used to do this all the time without injuring my back, if I focus on the movement and bend my knees correctly I will be fine. You need to give yourself CONFIDENCE that you CAN and focus on the task at hand!

I stopped running in circles the moment I realised I CAN! I can carry that box of fruit and vegetables from the car and I can vacuum.. Great, now I have no excuse to not do my chores!!

Beat the chronic pain cycle and say I CAN do it! I just need to take my time, concentrate and stop running in circles!

In my next blog, I will explore how the brain contributes to why a back that has no physical acute injury can be in so much pain.

Until then, happy moving everyone.

Feel like you can relate? I would love to hear from you.

Email me @: claire@tailoredhealth.com.au

Claire Samanna 🙂

Volume 6

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Chronic pain. Just the word ‘chronic’ makes me cringe. The definition of chronic is longer than 3 months. At the age of 18, this concept didn’t cross my mind. I had multiple back injuries, extending well over a 3 month period but there was no way I was labelling myself as chronic as that age. So, how did this all happen?

Initially, I hurt my back at the age of 18 when I joined a rowing team. I was on an ergo in the gym when I felt this almighty pain shoot through the right side of my lower back. I could hardly move- I wasn’t sure I would be able to get myself home. After 5 minutes, I eventually worked out how to stand up. This was like no other injury I had had before- this scared me. After a couple of days the intense pain wore off and I resumed life as normal with a slightly unhappy lower back.

Since the injury I have never returned to rowing as I was too scared that I would redo the same injury. This didn’t bother me too much though, as netball was my number one sport. What concerned me was that in that same year, I re-injured my back 3 times during games of netball. This bothered me. Over the whole year I sat out for 9 games of netball and played another 8 half games. My lower back was stopping me from doing the thing I loved to do the most.

My team mates would ask me, what is wrong with your back?  I didn’t know. A couple of diagnoses were thrown around by health professionals like facet joint jam or muscle strain, but nothing definite.  After every re-injury I would seek professional help, where I would be given stretches, a quick massage and I was sent on my way. The line, ‘You’re young and active. You will be fine in a few weeks’ was often mentioned.  The only problem was I wasn’t being active when my back was injured. How could I convince myself to do exercise when I had a back injury?  My immediate reaction was to rest, protecting my back from any further damage. I planned to strengthen my back and core when the injury healed and the pain left. However it never left and therefore I continued to wait before doing these exercises.

Many years later, after undergraduate and master’s qualifications in exercise sciences, seeing a number of health professionals, as well as my own self-directed research, I can see how very wrong I was. One day google pointed me in the direction of chronic lower back pain- a criterion which matched my story to a T. This is the point I stopped treating my lower back as an injury which needed to be diagnosed and rested, but as chronic pain, which needed to be managed.  This marks the beginning of my self-management journey. A journey, like any with highs and lows and one I will be exploring more in future blogs.

For today, I want to make the point that accepting I had chronic pain allowed me to stop playing the waiting game. Instead, I was able to get on with other aspects of my life, while my back pain was still present. I can compare it to waiting for good weather to do something fun. The perfect day may arrive, but for some reason you wait for a sunnier day. So why not start today!

In my next blog I will talk more about the chronic pain cycle and how this circular motion had me running in circles for a very long time.

Until next time ☺

Please post any comments or questions below.

Feel like you can relate to my story? I’d love to hear from you.

Email me @: claire@tailoredhealth.com.au

Claire Samanna