By Vanessa Shribman

    A young woman presented in my clinic a few years ago with lower back pain. She had suffered for almost a year with persistent pain following a fall and had visited numerous health care professionals without relief. She said she felt like an old woman and believed that she would be in pain forever. Not only did she feel limited in the physical activities such as exercising and socialising, she also could not sit for long and often felt depressed and quick to anger. Her pain made her frightened to move which led to significant deconditioning and higher chances of reinjuring herself.

    She is one of the millions of Australians who will experience chronic pain at some point in their lives. Chronic pain is defined as pain lasting for more than 3 months. Once chronic pain sets in it dominates how we feel about ourselves. We will often limit our activities thus becoming isolated and depressed. The good news is that science understands why pain persists and how we can change it.

    Why pain persists

    Neuroscience tells us that while the brain is constantly changing, pain can become hardwired into your brain. Although an injury may heal, the brain is still on high alert and triggers at the slightest provocation. It is a bit like your brain being a busy call centre. Prior to your chronic pain it would take many calls all at once to increase the noise in your body but, in trying to protect your body, your brain now responds to just a few short and innocuous calls for the body to be in pain.

    Pain also persists because we stop moving due to fear of reinjury. Our bodies were designed to move. Every part of the body needs movement to stay healthy. A sedentary lifestyle leads to weaker muscles and less resilience to injury and pain

    The way out of chronic pain

    There is extensive research on how to free ourselves from chronic pain and much of it is based on starting to move safely. Graded movement changes the rewiring that has occurred in the brain and reduces the firing of the circuits when you move. The essential advice is that the activity needs to be gentle, slow and mindful. Yoga is a perfect activity to segue from a passive lifestyle where you are frightened to move to a confident, active life. Find a gentle class with an experienced teacher that can guide you safely through fear of movement.

    However, there can still be a physical reason for some of that pain to be triggered. For instance, a back spasm caused by a disc bulge can cause the muscles and joints around the lower back to adapt, and without hands-on therapy, they can shorten thereby increasing pressure on the disc, causing more spasm.

    There is a way out of chronic pain. Find skilful hands-on therapy and a gentle exercise program. Be courageous and start to move. 

    Vanessa Shribman is a Holistic Physiotherapist in private practice in West Footscray, a senior yoga teacher, meditator and childbirth educator. She teaches yoga at the Body Voice Centre in Footscray.

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