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Understanding Pain: Why do we “pick the scab?”

The following information is from a great book meant for the non-physician to help resolve their own back problems--The book is by Stuart McGill PhD and is called “Back Mechanic: The secrets to a healthy spine your doctor isn’t telling you.”

I highly recommend this book if you have or are suffering from low back pain.

Basically the end goal with care and treatment is to remove the stressors and spare you spine with proper movement and strengthening exercises.

I have talked about this concept a little bit before in my previous blog, "Understanding your Low Back Pain"--a major cause for low back pain is poor posture during every day activities.

So I can agree that many back pain sufferers would experience a huge breakthrough in their recovery if they only realized that is was their flawed movement patterns that kept them pain-sensitive.

Much like a scab forming on our skin, our backs are constantly trying to patch and health themselves. We, however, by continuing to repeat harmful movement patterns in our daily lives cause re-injury. We are essentially “picking the scab.” It is unreasonable to expect the body to heal if we continue to provoke it in the same way that led to the original injury.

Continued provocation of pain sensitizes the nerves so that the pain is triggered with even less stimulation. Remove the provocative motions and we can find the solution.

Here’s how pain sensitivity works:

People increase their sensitivity through repeated stressful and painful loading. These muscles and joints are loaded with sensors: pain sensors, pressure sensors, force sensors, chemical sensors. Some detect carbon dioxide; some detect pain, some sense histamine for inflammation. Human joints are packed with sensors that relay position and movement information to the brain. These signals travel along the sensory nerves. Along the highway of nerves, there are checkpoints or “gates,” at junctions. According to the Gate Theory of Pain, the idea is, to flood the checkpoint with “good information,” in other words, signals associated with pain-free movement. In this way, there is no more room for the pain signals as they are crowded out.

Finding and repeating pain-free motions in your back will cause the remaining painful activities to hurt less. Read this again.

By discovering and engraining positive movements for your back, you will find that the pain often dissipates and then disappears entirely. This is because when we remove pain triggers and stop “picking the scab” we give our tissues a chance to rest, heal and regenerate. Simultaneously our sensors for pain are actually being desensitized. Master this, and you have mastered your back pain.

For those of you that have a known type of injury, a name to attach to your condition, your personal recovery strategy should always begin with avoiding the aggravating posture for your unique spine is key to getting yourself back on track.

Various symptoms of back pain have a distinct and known cause (although this information is not widely known making this book uniquely valuable). Injuries can be avoided if we avoid the injury mechanism itself.

Why Maintenance Care?

It's the exact reasons I've mentioned above that I mostly encourage patients to proceed with some type of maintenance care. The term "Maintenance" is defined different for everyone. We all work different jobs, we all sleep different ways, we are all exposed to different mental, physical, and emotional stress everyday. So what works for Joe may not work for Nancy.

This type of care is to maintain the progress and pain free movements. As we get you out of pain and begin swapping out painful movements with pain free movements and give the body a chance to heal we slowly start to go back to old habits. We are creatures of habits. So while temporarily the same old movements aren't causing you pain anymore eventually the repetitive movements will lead again to injury. This is why people often feel the same type of pain on and off for years--because we are doing the SAME types of things that caused it in the first place.

So unless we can completely change our habits, change the way we sleep, the way we bend over and pick something up, the way we sit etc. we will always go through the same process.

Maintenance adjustments help break the cycle and keep it from getting to the point where you feel pain.

Check out the quick video below for a better explanation.

As always, if you have any questions. Feel free to reach out :)

-Dr. Kristen

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