True or false: The worse the pain the more the damage

This may seem strange, but we now know that more pain does not always mean more damage.

People with similar back problems can feel very different levels of pain. The degree of pain felt can vary according to a number of factors, including the situation in which the pain occurs, previous pain experiences, your mood, fears, fitness, stress levels and coping style.

In fact, two individuals with the same injury can feel different levels of pain. Furthermore, the brain has the ability to ‘inhibit’ or turn down the volume and intensity of pain.

The tissue that has been injured cannot generate pain – it can only send messages to the brain to indicate a possible “threat”. It is the brain that interprets and processes these messages as 'pain' or 'no pain'. So the brain plays an important part in regulating if you feel any sensation, such as pain at any given time and how much you feel.

If you have persistent low back pain it might be that your whole nervous system (including the brain), which is involved in sending and processing pain messages is relatively more ‘active’ compared to other people, almost like a burglar alarm that is set to a sensitive setting. This can mean you feel more pain when you move or try to do something, even though you are not damaging your spine.

In fact, there is clear evidence of changes in brain activity in people with long-standing low back pain. A person’s genetic make-up, as well as environmental and personal factors, are also important in determining how we each experience pain.

Thankfully, a number of strategies, including a gradual return to activities, exercise, and education about pain, can be used to help lessen the pain and disability experienced. Research shows that once people with low back pain understand that the pain or ‘hurt’ they are feeling is not causing further ‘harm’ to their back, it is easier to participate in activities and exercise.

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