Back pain that presents to a GP or physiotherapist tends to be of 3 main types. So we’ve have got non-specific lower back pain which is a simple back pain. We’ve got back pain which is due to a nerve problem and we’ve got back pain which is due to other conditions which tends to be a bit more serious. So, things such as cancer or fracture and some forms of arthritis. So, there are really 3 categories of lower back pain presented to primary care.
What does ‘chronic’ back pain mean?
So acute usually means less than 3 months. Chronic means greater than 3 months. For management, the issue is that when people have had back pain for a long time, this is chronic lower back pain or persistent lower back pain, usually affect other part of the life not just the back pain. So, people start to have problems with their relationship, with their family, with their spouse. Sometimes it impacts upon their work, and if you have pain for a long period of time it affects your mood and the way you think. So chronic lower back pain usually has all these other things associated with it but if you usually got a fresh brand new episode of back pain, it usually just got the pain and disability associated with it.
It’s very rare for you to just have the pain experience. You cut your finger you just have the pain experience but if you have pain for a long period of time or if their’s uncertainty, there is all sort of things that happen. We talk about biopsychosocial that’s a complex term but it really means that pain is experienced with you thinking about it so that is psychological but there is also a social environment, so what your colleague is saying to you about your back pain, what your boss is doing, the compensation systems, this all influence people the way they express their pain so it is a really complex thing and if you think about it just as pain, it is really too simple.
What are the common myths about back pain?
I think there is some unhelpful messages in the community about back pain. Sometimes people think once you get back pain, that’s it, that is end of their life. The usual statistics are if you have a new episode of back pain, 50% of people recover completely within about 2 weeks with simple care. What we now understand is that a lot people have episodes of back pain that settle fairly quickly and it is actually quite uncommon to have long term disabling back pain. You will hear people say that got back pain that comes and goes. The people who are out of work, they can’t function, they have problem with their social relationships, completely disabled because of their back pain, that is a small number of people. And so people shouldn’t fear that because it is a very rare outcome.