Knowledge is power!This is the primary reason for educating people about back pain. We want you to understand and accept better what is going on with you rather than living in fear of thinking you are doing something that causes you more damage and more harm.

Most people do not understand that there are two kinds of pain. Acute pain is the kind that we usually identify with injuries, for example, when you cut your finger, break leg, and so forth. With acute pain, after you have healed, your pain goes away, as well. Chronic pain persists even when the stimulus for pain is no longer there. Chronic pain can happen for a couple of reasons. You can have a problem that is not “fixable” with traditional medical treatments such as epidural injections. The other kind of pain occurs when the nerves no longer are being stimulated, but they continue to send messages of pain. A good example of this is phantom leg pain. An individual may lose a leg but two years down the road still feels the leg is there. Such individuals may complain, “my toe hurts, I’m having pain in my leg,” and so forth. How can this be?This is similar to the chronic pain that some people get. But just because there may be no identifiable problem, this does not mean you don’t hurt.

Chronic pain occurs in 3-5% of the world’s population. There aren’t very many of you out there, and you are misunderstood people. Chronic pain is not only misunderstood by the lay population, for example family and friends, but also is not well understood by medical professionals. You may feel that medical professionals, including physicians and physical therapists, look at me funny after I say I’ve tried everything including PT and I know it has helped other people. You may feel like they look at you as someone who is a “wimp” or as someone who is milking the system. You may have even been told that your problem is “all in your head.”

These kinds of comments may have resulted in your feeling angry and frustrated. When you are in this state, your muscles tighten and you have more pain. It creates a big cycle. Chronic pain creates considerable stress—just because it is not identifiable, doesn’t mean you don’t have genuine chronic pain.

Hurt versus harm—is there a difference? Yes. Let us explain. We can use a sports analogy. An athlete can be hurt while practicing or competing, his or her leg is put in an immobilizer or cast, and we don’t expect that athlete to return to his sport the next day. He has to go through healing and rehabilitation. At end of the rehabilitation, the athlete has a decision to make: do I return to athletics and possibly hurt myself, or does the athlete decide it’s not worth it to me to face the prospect of harming myself again and facing constant pain.

The same thing happens to people who are not athletes. Almost everyone requires rehabilitation after an injury. You may always have discomfort and pain. But you have a decision: do I let it stop my life or do I “play” through it. Let’s give you an example of hurt associated with daily life activities. It is spring, you get excited, and you go outside and enthusiastically start preparing your garden. This is not something you have done for a while. You are using different muscles and you very well may get sore afterward. Many people may find that they “hurt” when they do things they have not for a while (or at all). They may ask themselves: is this just an expected “hurt” or is it something more?We are taught as children that pain is a warning. We pay attention to pain and try to do something about it. This happens with what we call “acute pain” but not for those with chronic pain. When you have back pain, you usually back off for a while and resume your activities after a few days. This is the same thing that people with chronic pain do. They do their prescribed exercises, hurt a lot, back off and don’t do them for a few days only to return and find that the same cycle occurs. It often feels like you hit a wall. You never get past that wall because you fear you are causing yourself harm or damage. This fear stops most people.

After you are medically evaluated by a spine doctor and the doctor has told you that it is safe to participate in rehabilitation, then you need to believe and trust that nothing you will be asked to do in a rehabilitation program administered by a licensed physical therapist is going to harm or damage you. This does not mean that we don’t believe you hurt.

A committed physical therapist can give you the tools to become as functional as you can be physically and emotionally, but you will still have some discomfort. We do not promise to “cure” you of all of your back pain.

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