Overview
Why does some low back pain persist?
Pain can persist for a number of reasons but sometimes pain can persist even when the original injury has healed. In this case, the nervous system has become sensitised or amplified, and normal messages coming in from the outside are interpreted as 'pain' by the brain.
Pain can often lead to restless nights or poor sleep patterns; this makes the problem worse as our pain threshold is lowered with poor sleep.
Stress and anxiety can really amplify the pain messages also. To calm down the nervous system, which essentially helps lower the incoming pain messages, it is necessary to learn to relax. This can be easier said than done!
How does pain change our movement?
People with pain often move differently. This is because our bodies are designed to react when we have pain, and pain motivates us to change our behaviour. However, if guarded movements persist, this can lead to stiffness and increased compression through our spines. It is really important to return to moving normally again.
After experiencing pain, sometimes the most frightening thing can be the fear of it happening again. Exercise will help prevent your pain from recurring. It does this by strengthening and conditioning your body.
What is Cognitive Functional Therapy?
Cognitive functional therapy is a patient-centred approach that targets the beliefs, fears and associated behaviours (both movement and lifestyle) of each individual with low back pain. It leads the person to be mindful and understand that pain is not necessarily a reflection of damage to the tissue – but rather a process where the person is trapped in a vicious cycle of pain and disability. This can further be fueled by a nervous system that is stressed and sensitised due to pessimistic beliefs, fear, lost hope, anxiety and avoidance, linked to unhelpful movement and lifestyle behaviours.
It empowers the person to challenge the very things they fear and/or avoid but in a graduated, relaxed and normal manner. It motivates them to exercise and live actively based on their preferences and goals.