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Your Therapist Isn’t Interested In Helping Your Back Pain

Why Are You Still In Pain?

Have you seen a lot of therapists and tried a bunch of therapies but you’re still in pain? You’re not alone. Here’s the problem . . .

Therapists treat your pain with the modality that they learned in school. If they’re a massage therapist they’ll say “Let me give you a massage that’s what you need. . . ”

And this happens all the way up to the highest paid professionals. Sound familiar?

I know because, as a massage therapist I did that myself.

Understand Pain Neuroscience

Until good science came along, hurt my feelings for telling me what I learned was wrong, and questioned my sincerity and integrity while promising that if I humbly edited the original information I could gain a more robust client-centric version, become a better therapist, and more importantly get better results. 

Being humble is hard, but I try and the results are miraculous. 

Neuroscience tells us the reason why the strategy of forcing a treatment/therapy/modality onto pain to erase it isn’t an evidence based approach, it’s basically guessing, and guessing isn’t very effective. 

Pain Is More Than Just A Sensation Like You’re More Than Just A Human

The International Association for the Study of Pain defines pain as both, and always a physical and emotional experience. I’d add to that that pain is not always a consequence of physical injury, and that a better word that they could used rather than “emotional” is “contextual.” So, pain is both and always a physical and contextual experience. But they’re the experts, not me.  

The reason why I say this is because pain is an interpretation of what’s going on in the body by the nervous system (brain and spinal cord). 

Your brain’s most primitive job is not to think, but to react, specifically, to keep you safe. This means your brain is really good at remembering past perceived dangers as well as predicting future danger, especially the threat of death. This is obviously important, but it can be very, very misleading because for 95% of people that extreme assumption is our brain’s default setting. 

A Crazy Pain Story

There have been literally thousands (but actually more) incidences where what someone thought and felt was severe pain from bodily injury, was simply their safety/fear/predictability mechanisms kicking in. There’s a popular story of a construction worker who fell and a large nail pierced his boot. He was screaming in pain and when he got to the hospital and they removed his boot they found the nail went between his toes without actually piercing his foot. He was perfectly fine. But thought he was in serious danger so he felt excruciating pain. 

This Happened To Me

To make this more real for you an incident happened to me when I was first learning pain science. I was in the kitchen cooking dinner and had my toddler in a backpack. He reached over my shoulder and grabbed a plastic measuring cup. As quickly as he grabbed it he dropped it and it landed on my foot. I was in excruciating pain. Because I I took this moment as an opportunity to test some of the information I learned. I looked down at my foot, there wasn‘t any blood. The measuring cup weighed about as much as a writing pen, so it was nearly impossible that a bone was broken . . . after realizing that there was no danger I checked back in with my body and the pain was gone. Yup, my brain created the pain as a safety mechanism so that I could protect myself and rule out any severe danger. 

If you’re reading this for the first time you’re probably saying, it makes sense in my brain, but in my body pain feels very real. Yes, I’m not questioning your experience. The sensations are real, but they don’t necessarily mean there’s tissue damage or something wrong. In my postsI’ll give many instances where this has been the case, but let’s return to our discussion on back pain and therapy.

Choose A Therapy Based On Evidence-Based Reasoning, Not Simply “Because It Works”

It’s my guess that the therapies you’ve tried have generally only targeted the body in some way or another, correct? And they were probably helpful, for a period of time. I’m not saying that your pain is all in your head. The brain and nervous system are very complex, so that means pain is not simple, but that’s also why pounding on the part where you feel pain, stabbing or piercing the body with sharp tools, cracking things, numbing nerves, and even replacing parts aren’t very good or very precise ways of changing pain. Unless the therapist used an evidence-based assessment and had good reason why or how their therapy would be effective.. 

You Are Unique And So Is Your Pain Experience

Pain is an individualized complex puzzle. As a unique person, who you are, what you do, how you move or don’t move, what you believe, what professionals have told you about your pain, etc, all matter in terms of how your brain processes and interprets the signals that go from your body to your spinal cord and brain. Don’t get me wrong, massage might work, it can be very effective, but we therapists should be able to give good reasons why their work can help based on the latest science. 

Pain Is Not Tissue Damage, But It Is A Message

Here’s another example. A few years ago I nearly cut off the tip of my finger. As you can imagine, it was excruciating. The first thing I did was raise my hand over my heart, squeezed my wrist, calmed down and got the bleeding to slow down. Then I bandaged it. After a few minutes the pain was nearly gone. It wasn’t excruciating like it was at first. There was still tissue damage. Why was there pain? 

Become Resilient

Because pain is an interpretation by the brain of what’s happening in the body. If there’s a serious threat or the spinal cord/brain perceives that you’re in danger then it’ll (hopefully) make you feel a lot of pain, but once that threat is taken care of (in a healthy resilient system) the pain will subside. 

Therapies help through different mechanisms. Many therapies are like a mother who consoles her hurt crying child. They tell our bodies and brains that things are ok, that we can calm down, they re-establish trust and safety, and the pain goes away – the child who was crying 10 seconds ago is smiling and running around laughing with tears in her eyes. When we do something that disrupts that danger belief then pain can down-regulate.

With my clients, I believe it’s not top down psychology that I do, and it’s not purely hands-on stuff. Taking client history and who they are into consideration, effectively treating people with pain is a combination of different things as well as helping them connect their brains and bodies in order to apply information. 

In my opinion, the most important mechanism of effective therapy is to help people connect back into their bodies. This sounds strange because it’s impossible to literally “disconnect”, but we fight through, distract, ignore or in other words “disconnect” when we have pain. Clients are truly helped when they can reconnect and experience sensations again and are able to process sensations in reasonable, resilient, and healthy ways. 

I do this through old school hands-on therapy, novel movement coaching, and neuroscience. I hope this is helpful and gives you new perspectives on pain. what is going on, and how to approach your issues.

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