If you are suffering from back pain, you are probably thinking there’s a problem to fix:
Do I have a herniated disc (or slipped disc)?
Is my pain due to “wear and tear” in the lumbar spine?
Perhaps one of my spinal nerves pr spinal cord is compressed?
Let’s take a step away from that. Today, what I really want to focus on is how you can help yourself even without a clear diagnosis.
Just in case, I have gone mad, check out this commentary by orthopaedic surgeons published in Journal of Neurosurgery just a couple of weeks ago: Generating alpha: can we prevent a back pain bubble?
“Unfortunately, the best strategy today must be to ask the right questions. And to do so, we must first acknowledge this looming economic risk in the field of spine surgery. As I explained to the Lees, there are no moonshots: he eventually underwent a minimally invasive procedure that significantly improved his pain. Further improvement came with Mr Lee’s personal commitment to rehabilitation and physical therapy. Although Mr Lee’s pain never fully resolved, he is now able to work again.”
So today, let’s ask the right questions to help you find freedom from pain.
1. What are your recovery goals?
Most people consider being pain-free to be a recovery goal.
Yes, it is. Just not a good one.
For most parts, I help my clients to set goals following the SMART goal criteria. Your goals have to be: Specific, Measurable, Achievable, Relevant, and Time-bound.
Being pain-free is more of a perfect future. You know, how things would look when you win a million-dollar lottery or when you found out you are an heir to a billion-dollar empire you never knew about.
Aspiring to be pain-free one day is okay. But what would really help is if we can set goals that are more tangible. What would like to achieve over the next six weeks or twelve weeks given where you are right now and your current circumstances.
Your goal has to take into consideration your current condition and also your current circumstances.
That means if you are struggling to walk because of your lower back pain, it may not be reasonable to expect yourself to be able to deadlift your own body weight within six weeks.
Maybe you can already deadlift 50kg before you experience pain. If you are travelling for the next six weeks and do not have access to a gym where you can train at, deadlifting an additional 10kg (from 50kg) is not a reasonable goal.
When it comes to setting goals that will actually help you, follow the SMART criteria. While you are working through it, don’t forget to consider where you are right now (i.e. current back symptom/function) vs. your current circumstance (e.g. stress levels, availability, sleep quality, exercise, etc).
2. How do you know you are getting better?
So you have set yourself a goal you’d like to achieve. Let’s say to be able to sit at your office desk for 4 hours without back pain. You have considered that to be a reasonable goal.
Here’s the next question: How do you know you are on track to your goal?
Start tracking your sitting behaviour as well as how your pain changes through the day.
It doesn’t seem like much but it can make a difference for you.
I once worked with a client who was not feeling better day to day even though from an objective perspective she had made tons of improvement. Her range of motion (ROM) was largely full and pain-free. Her movement patterns were good – she had smooth, controlled movements through her entire ROM. She was able to lift weights that she couldn’t before. She also did very well with statistic exercises.
But her daily symptoms did not change!
We started to work today on a daily log basis. This client would jot down how she feel day to day before lunch and after lunch. After one week, it was clear what was going on. She was largely pain-free for the first half of the day and her pain worsens at the end of the day.
Because she didn’t know what recovery would look like in her case, she didn’t realise she was, in fact, slowly getting her. She no longer wakes up with morning pains. She now experiences episodic back pain – mostly at the end of the day – instead of the previous constant, lingering pain.
You see, she was getting better. She just didn’t realise it.
It’s very important that you know where you are with your symptoms right now. From there, you should be able to work on how it would look for you if you are indeed starting to move towards your goals.
3. Pay attention to what is working
Don’t over-focus on what is wrong or what the problem is. Look beyond that to figure out what already makes you better in your day to day life.
Living with chronic pain is an awful experience. Trust me, I know because I’ve been there. I’ve lived with low back pain for most parts of my early 20s.
This will take effort but do try to consider how your symptoms change from day to day.
I know, I know. It feels like it’s always bad! Let’s take a deep breathe and, in baby steps, figure out the nuances of your lower back condition.
As much as possible, do a symptom check-in on a regular basis.
Perhaps once a day at lunch? Perhaps every 2-3 hours through your work day. Find something that works for you.
Have a think about how your pain intensity feels right now as you are reading this. How would you rate it on a zero to ten scale. It doesn’t matter if you are commuting on the train, being distracted at work, or trying to get to sleep in bed. Let’s just take a quick self-assessment.
How’s your pain like? Are you having muscle spasms?
p.s. It doesn’t matter if you have a high pain threshold or low pain tolerance. This is all about you.
You can also make other observations: where is your pain? Are you able draw out the boundaries of pain? If you can’t, don’t worry. It’s perfectly normal.
If you feel like the bones in your spine are not aligned, don’t worry about it as well. It’s normal for people in pain to perceive the spine to be out of alignment.
Now that you know how to do a quick assessment, I want you to consider doing this on a regular basis.
Because, I want you to start thinking about what makes your good days good!
So the next time you feel like your pain is a 4/10 instead of a 6/10, I want you to consider what might have made it better?
If your back pain used to cover the entire back but now only affects you on a very small area just to one side, I want you to consider what might have made it better?
Once you can identify the patterns that improve your symptoms and do more of those things, you will bring yourself closer and closer to recovery!
It’s common for people with back pain in Singapore to into magnetic resonance imaging (MRI) scans to try to find out what’s wrong with their spinal column or to check that their nerve roots are all healthy.
You don’t have to do that. Current guideline recommendations do not encourage MRI scans for back pain.
What is more important is to look deeper into your lifestyle and focus on long-term strategies you can adopt to improving your life.
To achieve your goals of living pain-free, start with the small things you can easily do in your daily life. Doing what works for you – over and over again – for a period of time will help you develop good habits to reduce your risk of future pain episodes.
Low back pain is multi-factorial in nature and often has a lifestyle and/or psychosocial component.
Skip the treatments that promise quick results with a chiropractic adjustment or a session of dry needling. They aren’t good long-term pain solutions.
If you have wasted time on useless treatments and would like to start working on personal development towards pain-free living, book in with us via the appointment form before. Discover the difference the right treatment can make.
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Frustrated by the lack of results-driven and ethical chiropractic clinics in Singapore, Chiropractor Jesse Cai found Square One Active Recovery to deliver meaningful and sustainable pain solutions.
Our goal? To make our own services redundant to you.