Chronic Back Pain: A Guide for Patients and Families

Understanding chronic back pain

Many people go to their doctor expecting an easy fix for their back pain. 

Typically, the cells creating that pain are otherwise healthy nerve cells that are overactive or malfunctioning. They don’t stand out in tests or images like diseased cells, and to eliminate them would have bad consequences for the patient. 

The key to understanding chronic pain is to think of it as coming from an over-active and over-responsive nervous system.

Our approach to your chronic back pain

First, your doctor should evaluate you

If you have chronic back pain, your doctor will investigate to see if there are any significant disease processes causing it. These include some very serious and sometimes fatal or life-changing conditions, such as:

  • Cancer
  • Fractures
  • Infection
  • Other diseases of the spine

Fortunately, this only occurs in about 5 percent of people with chronic back pain.

But if there are no obvious findings on your physical examination, X-rays, MRIs, CT scans, or EMG tests, then you should be reassured that these more life-threatening things that can cause pain have been eliminated.

Most importantly, we can teach you about your chronic pain

For many with chronic pain, you are in much more control of your pain than doctors are. Be aware that the way you view your chronic back pain is extremely important. If you are fearful of movement or think the worst of your back pain, you will not do well. This is why teaching you about your chronic back pain is one of the most important things doctors can do for you.

Don’t think of back pain as a debilitating disease. Start thinking of your chronic pain as signals in your nervous system that come from your physical fitness and previous injuries and your nervous system being over active or over responsive.

Physical condition

You have muscles that are telling you they are stiff, weak, and need more endurance. Most people with chronic pain are no longer in the best shape of their lives. An injury may have occurred while you were in good shape, but after the acute injury has had time to heal, you may have noticed:

  • Weight gain
  • Stiffness
  • Lost strength
  • Poor endurance

Getting back to the same level of fitness may or may not be possible depending on how much effort you put into your overall fitness.

Over-active or over-responsive

You have a nervous system that amplifies normal muscle signals. Blocking and even reading these pain signals is beyond the technology that we currently have in medicine.

If you start thinking of your pain while acknowledging these facts, you will slowly understand that a complete elimination or silencing of your pain may not be possible. You may need to focus on a more practical solution, such as managing the pain. This is why physical exercise can be helpful in making muscles more fit and mental exercise can be helpful in decreasing pain. People who successfully manage their pain are able to get back into age-appropriate work and recreational activities.

Last reviewed: 
April 2018

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