So far in this 3 part series (of which this is part 3) looking at the PAIN = DAMAGE myth, we’ve come to understand that:
- Pain is not an accurate indicator of tissue damage
- Pain is an output of the brain that is projected onto your body
- The experience of pain is greatly influence by context, such as the language we use to describe our pain
- Misinformation and untrue beliefs about our health and bodies can lead to an increase in pain
And so if you’re dealing with long-standing pain, then let me give you 3 truths to combat this myth and help you with your own pain:
- Your body is fundamentally strong – A lot of you may be familiar with the statistics that come up in Health and Safety and Work, that say when you’re sitting with bad posture or lifting a heavy box with bad posture double the amount of pressure is put on your back. The original research for these statistics was conducted on cadavers – that is people who have donated their bodies to science for experimentation after their death. And so this study confirms something very obvious to me – that dead bodies shouldn’t sit in chairs or lift heavy boxes. Your living tissues are actually remarkably strong and resilient and it’s harder than you think to cause serious damage. And, importantly from that piece of research, even the highest amounts of pressure measured in those cadavers were well within tolerance levels for a living spine. You are not a fragile structure.
- Don’t fear movement – it’s a common misconception that bending is bad for your back. And we hear all the time that we have to hold our spine really straight and brace our core before any movement in our back. But honestly, stiffening your back like that is a really unnatural thing to do. On the other hand, there is strong evidence of the many benefits of staying active to reduce pain. In fact keeping mobile, and for many people this would involve staying in work, results in less pain and a faster recovery. So don’t fear movement – “motion is lotion”, as they say.
- Your body is healing – think back to last time you had a cat scratch or a paper cut. How long did it take to get better? Would you be surprised if, after a year, it was still bleeding? We are so used to our skin healing and repairing itself, but we often don’t have the same faith in the bits we can’t see, like our joints. But the same immune cells that heal your skin and working all the time to repair all your insides too. And they’re constantly at it – healing and protecting, healing and protecting. So you can have some faith – you are always repairing and getting better.
Now I think that this topic is so incredibly important because a misunderstanding of pain and a fear of our bodies can be a huge burden for the individual. Patients tell me all the time that they’ve stopped doing things that are important to them, because they just don’t trust that their bodies will cope. One patient told me that she felt she had no choice but to have an abortion because of the unbearable strain that a pregnancy would put on her back.
But the impact is not just felt at the individual level. Low back pain and neck pain are both leading causes of time off work in Britain. And the UK, like most other European countries, spends between 2% and 3% of GDP on its treatment. In fact the treatment of persistent pain costs more than diabetes and cancer… combined.
Imagine how this would change if we threw out the pain = damage myth. If instead of spiralling into inactivity and fear we remembered that we are strong and capable of healing. How liberating would it be if we remembered that movement will build our bodies and not break them. And how empowering would it be if we recognised the ability of our brains to control our pain.