In the future, we're going to think about back pain very differently. In fact, researchers predict that the way we think about pain is the way that we will manage it.
It was only in January this year that scientists at the University of Colorado definitively proved that there is a dedicated pain pathway in the brain that has no link to the body, rather, to our thoughts and emotions.
Armed with this updated information, clinicians will need to shift their approach to address the psychological elements of back-pain that have been over looked for too long.
Perhaps it is not surprising to find that mind and body are not separate entities, but interlinked in various complex ways. The challenge for us in the present is to understand this and accept that we have to rethink our approach to care either as consultant or patient. Pain generated by the brain is no less real than if it is generated by the body, even if it is not visible to the human eye.
Where people are suffering chronic pain, and pain-relief medication that we are familiar with, such as paracetamol, ibuprofen and opioids, are not having the desired effect; assessing the psyche, the attitude towards the pain is the key to achieving the breakthrough in pain management.
Physiotherapist, Sarah Key, author of The Back Sufferer's Bible supports treating emotional aspects of back pain. "I think there were two dual processes going on in my mind – one was how outcomes had very little to do with the pathology shown on the scan and a lot to do with the patient's psyche – to do with stuff like being a catastrophiser."
Take this simple example as an analogy: two women lose their job on the same day. The first reacts by consuming large amounts of alcohol daily and shutting people out. The second reacts by taking some time to decompress, socialises with loved ones and begins searching for new opportunities. It is the attitude of the second woman that helps her achieve equilibrium instead of prolonging the negative event. With the right kind of support, the first woman will have the tools to overcome the source of pain too.
So what can you expect from your GP if you report back pain in five years time? As well as a referral to a physiotherapist, we reasonably predict that you will also be required to undergo brain scanning procedures so the doctor can fully appreciate what you are experiencing. There will be integration of proven physical and psychological methods to promote healing. Massage may identify the problem area, and cognitive intervention will reduce anxiety and stress, which as you are already aware of through experience, cause tension and knots in the muscles.
This is a fascinating area of medicine impacting up to 80 percent of Australians who experience some form of back pain. Through education and treatment we can move forward and look forward to a pain-free future.