Chronic back pain is often associated with an increased sensitivity to pain. Changes in the spinal cord and brain can occur when pain persists for a long time, which contributes to back pain being experienced out of proportion with the actual damage to spinal soft tissues (1). When back pain has been present for an extended period of time, the central nervous system becomes hypersensitive to pain, and can even cause pain to be felt from non-irritating stimuli such as normal touch or pressure. This is known as central sensitization and is part of neuropathic pain.
While different types of chronic pain and different individual perceptions of pain stimulate different brain regions, they all have a tendency to shift away from actual tissue irritation (alarm or danger signals from back soft tissues), and instead shift toward emotional and motivational brain regions the longer the pain lasts (10). Thus, chronic pain is likely to result from other influences in addition to soft tissue damage. In fact, the resting brain state actually becomes distorted in chronic pain (10).
Psychological factors have been found to have a clear relationship to the development of persistent pain (1). Because the central nervous system increases in activity during back injury as well as during an emotional response, it turns out that many chronic back pains are worsened by anxiety, stress and depression (1,6,7). These and other negative thoughts can actually trigger a pain reaction in the brain (1).
The bottom line for chronic back pain sufferers is that multiple factors often need to be addressed to find lasting relief. While professional therapy for psychological issues such as depression, anxiety, and underlying mental illness can play a pivotal role in healing, other interventions such as cognitive behavioral therapy, mindfulness and positive self-talk have become viable interventions for chronic back pain as well (1,2,3,4,8,9,10).
These therapies do not always need to be administered through a professional to be successful. Self-management for addressing many aspects of the bio-psycho-social complex is becoming increasingly more popular for lower back pain treatment, and can be quite effective. Spending some extra time thinking healing thoughts while out on your walks is the perfect place to assist your efforts of walking lower back pain away.
Walking is an opportunity to use personal psychology to change your thoughts, beliefs and attitudes, which when practiced over time help to desensitize your central nervous system and dampen pain. It’s up to you to decide what input goes into your brain to help assist or resist pain. You can control the switch that turns on the pain in your brain!
It all begins with becoming mindful or aware of how you think about your pain, and what emotions you associate with your back pain. From here, a change in thinking or perspective can occur. If there is a shift in thinking to a perspective that you can adapt (be re-conditioned), then pain and function can be improved. There is a strong link between negative beliefs and increased pain perception (5), and general reassurance that you can improve is associated with less pain (11).
The mind-set necessary for feeding your brain the pain relieving input you want consists of multiple voluntary decisions and perspectives including: 1- overcoming your fears to movement and gradually increasing your physical lifestyle, 2- making changes to your beliefs and attitudes about pain based on the fact that pain is made in the brain and does not equal the amount of tissue damage in your back, 3- changing your perspective from being a victim of pain towards viewing pain as a challenge to acquire problem solving skills to self-manage your pain, 4- adapting a healthier lifestyle, work and social environment to support your healing, 5- learning to relax and accept what life hands you, 6- focusing on what you can still do despite your pain using modifications of activities when necessary, 7- building a personal coping strategy to overcome flare-ups and negative thoughts/emotions, and 8- improve your self-efficacy by believing that you can get control over (and conquer) your back pain.
All of these factors help build faith and confidence in your ability to recover. The more of these various thoughts and actions you persistently pursue, the more positive input will be fed to your brain, and as a result, your pain sensitivity will begin to change. Your brain will have less negative material to build pain with, and instead will build a pain-free decision of safety and well-being.
While multiple specific strategies for addressing these factors are taught in the full Walk Away Back Pain™ Program, you can begin your healing thoughts using the following two psychological techniques of Self-Talk and Dissociation.
Positive Self-Talk is the practice of using repetitive healing thoughts to overcome your pain. It helps to match a specific positive self-suggestion or affirmation to a specific negative thought or emotion. For example, practicing replacing the emotion of fear or anxiety with an affirmation such as “I am going to be all right, the pain I am feeling does not equal the actual damage in my back, but is a result of many other factors as well, all of which can be overcome”, can be said out loud or contemplated in silence over and over to replace the negative thoughts of fear and anxiety. Positive self-talk helps you to re-program the way your brain responds to the various stimuli of thoughts and beliefs.
Dissociation offers relief by imagining a separation of your pain from your body. Visualize yourself in another time, or high above the earth, or sitting across the room in a healthy and painfree body. This often works well while walking, as you visualize yourself in a new body full of strength and physical robustness, walking with a relaxed, yet strong with a pain-free back.
Any of these mind-setting techniques can be used to formulate your own unique mental coping strategy for pain. Based on your specific targets revealed during mindfulness of your pain experiences, you will want to construct a personal self-talk or dissociation script that affirms the positive corrections to your typical negative responses to pain.
Start becoming aware of your thoughts associated with your pain, and use your walking time as a personal rehab sanctuary to practice your positive and healing thoughts. When you begin to change what you think about while walking, you will super-charge your ability of walking lower back pain away!
Dr. Michael C Remy, DABCO, CCSP is a chiropractic sports orthopedist who specializes in custom walking exercises for back pain and spine rehabilitation. His Walk Away Back Pain™ Program offers simple and effective back pain solutions through improved walking movements and techniques.
Disclaimer: Please be advised that any exercise or movement advice given is for general information purposes only. There is no intent to diagnose, treat, or suggest personal advice as per your individual health issues or status. Certain exercise and movement advice given here may be harmful for your condition, and may cause injury or a worsening of your condition, as well as other health problems. Always consult with your own doctor before beginning or changing exercises or body movements.
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