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Low Back Pain: Exercise and the Mind

Lower back pain, even chronic lower back, responds positively to exercise, according to a recent large Cochrane review. For years we knew exercise, physical therapy (PT), and education could could help people recover from acute lower back pain. The effect on exercise on chronic lower back pain was questionable at best until this Cochrane review came out. Despite the positive news, many physical therapists still question what are the best exercises and what other factors are important to recovery.

A fantastic article published from a member of the Chartered Society Physiotherapy in the United Kingdom highlighted the importance of psychology with recovery of chronic lower back pain. The author sites:

Furthermore, he said that that negative language and beliefs about the body, such as describing it as ‘a broken machine’ or suffering from ‘wear and tear’, can affect the outcome of an intervention. 

It appears the beliefs and attitudes of a person can have a majority of impact on recovery from lower back pain. It is important to see the recovery from lower back pain as a team effort, with you, your PT, and often family helping you through recovery. Our expert staff have the skills to guide you through exercises and some psychologic tools to guide you through low back to full recovery. In rare cases we use a sports psychologist trained in cognitive behavioral therapy (CBT) to help even more. 

Call or mesaage us today for a consult in Naples, Bonita, or Marco Island.

Failed Back Surgery Syndrome (FBSS)

Chronic lower back pain is one of the leading causes of permanent disability. Often people with chronic low back pain will try multiple forms of treatment including Physical Therapy, medications, and injection therapy. Once they've exhausted all these efforts, many resort to surgery as the answer for their pain. Unfortunately only 35% of these cases are successful, particularly when Fusion is involved. As such, a group of pain management specialist recently have begun to use the diagnostic "label" of failed back surgery syndrome, or FBSS.

In the article below you can read how many pain specialists feel adding this additional "label" as a beneficial step. I would partially agree that the "label" is beneficial because some Physicians and surgeons are in denial that back surgery can fail. Some surgeons see patients with continued back pain after surgery as fakers or addicted to pain medicine. Physical therapists, as well as modern educated surgeons and Physicians, know that surgery is not always the answer for chronic lower back pain. Moreover, I strongly feel that simply adding a label is not enough.

As a physical therapist, I argue that simply adding a label may not be as beneficial as what occurs in the next steps after a patient is diagnosed or labeled. A large majority of patients with chronic lower back pain never seek psychological counseling. Emerging pain science Concepts are beginning to show that many of these patients with chronic lower back pain, as well as other forms of chronic pain, have larger issues at play. Many of these issues include anxiety, altered pain responses, depression, and chronic systemic inflammation from poor nutrition and lifestyle factors. Physical therapist are being armed with the knowledge of addressing some of these psychological Concepts through cognitive behavioral therapy (CBT) techniques, modern pain science techniques, as well as nutritional counseling.

Our team at Wells Physical Therapy embraces many of these Concepts and can help you or our friend through chronic pain. Contact us today for a consultation and enjoy the below article.