Because thoughts are nerve impulses too…

Who is responsible for making the final decision as to whether something is dangerous for us, and determining whether action is required to overt harm?….The brain of course! We as human beings have a distinct advantage over animals, because we can learn quickly from experience, plan for future events, and make an attempt to predict outcomes.

This means we can recognise an event (or input) as potentially harmful before there is any chance for input at a physical level. This is all very well, and an essential survival mechanism for us. However, when the system becomes oversensitive (as it is in chronic pain states), inputs unrelated to physical damage, but judged by our brain as harmful, can be enough to cause pain.

It is well evidenced that some people with persistent pain need only to think about a particular movement or watch someone else perform a movement for it to cause pain. For some patients, even just imagining a movement is enough to cause a swelling in the painful part of their body. Many patients say: “It hurts more when I think about it.” From what we now know about pain, this makes perfect sense. Your brain has been trained to protect you from anything that it perceives might cause harm to your bodily tissues.

On top of all this, thoughts like: “my doctor thinks it’s all in my head”, and “someone I used to know had back pain, and they ended up in a wheelchair”are classified as threatening to a brain concerned about survival. Even being fearful of certain day-to-day activities, which you feel will stand a chance of causing you injury can increase pain. Often people cease common day-to-day activities because of this fear. We commonly term this: fear-avoidance-behaviour.

We all know that pain is transmitted by nerve impulses from the body to the brain, but it may be interesting for you to begin to realise that:

Thoughts and feelings are nerve impulses too!

Research has evidenced that thought impulses and patterns are so powerful, that they can maintain pain states within the body, even in the absence of any physical damage. Therefore, when all of your bodily tissues have healed after an injury, the pain can remain. For the sake of this article, we can call these unnecessary thoughts as: ‘cognitive distortions.’ Listed below are a series of the cognitive distortions concerning long-standing (chronic) low back pain:

“I’m in pain, so there must be something harmful happening to my body.”

“I’m staying home to rest, not going out. I think I’ll just keep out of things and lay low for a while.”

“Even their fancy new-fangled body scanner can’t find why I’m in pain. If they can’t find it in the first place how are they going to fix it?”

“I’m so frightened of my pain and injuring my back again that I’m not doing anything.”

“I’m not going back to work until the pain goes.”

This is just a small selection of the many cognitive distortions common to people in pain. What are your most common cognitive distortions, and what would happen if you were to begin to better understand them, and come to realise you have the ability modify them? If everytime a cognitive distortion popped into your head, you exchanged it for a more positive, suitable thought, how would that affect what you do…, your behavior…, your mood…, and even your pain?

So you’ve finally done it. You’ve fulfilled that resolution made several years in a row and started a long overdue exercise regime. In fact you’re probably one of millions who have made such a promise this year. Maybe you already exercise…running, gym work, swimming, tennis, football, golf, even gardening, we’ve all got our preference, and we all know regular exercise is important as part of maintaining a healthy lifestyle. People who lead an active life are less likely to become ill and more likely to live longer. Exercise not only makes you physically fitter, it also improves your mental health and general sense of wellbeing. So, what’s the issue? Well, nothing if we do things properly. The problem arises when our best intentions result in unwelcome pain and injury.

As a Doctor of Chiropractic, I diagnose and treat a wide variety of neuromusculoskeletal injuries and pain syndromes all over the body, which arise for various reasons individual to each patient. However, we seem to be seeing an increasing number of exercise induced injuries, the vast majority of which are caused by a faulty or ill informed exercise technique, and nearly all of which are entirely preventable. ‘But how can this be?’ I hear you say, ‘I’m always very careful, and my technique isn’t half bad.’ Well, correct exercise form is something of a fine art, and irrespective of this, underlying mechanical problems of the body can predispose individuals to certain injuries, even when they’re on top form.

Current research on the topic certainly emphasises this risk: A national UK study of exercise related injury estimated that each year 29 million new or recurrent injuries occur as a result of exercise, 9.8 million of which result in new ‘substantive’ injuries which are potentially serious, result in treatment, or in participants being unable to take part in their usual activities.

Now, don’t get the wrong idea. The benefits of exercise far outweigh the risks. However, the risks are there and deserve appropriate consideration, mostly because we remain unaware of them until it’s too late and we develop an injury. The pain of that injury exists to tell us that something isn’t quite working as it should be. However, the underlying mechanical fault that caused the injury may have preceded the emergence of pain by years, even decades. This is true of any pain, irrespective of whether it arises during exercise, and can be thought of in the same way that underlying arterial disease which develops over years usually precedes a heart attack or stroke.

So, what should we do when pain arises? The most recent evidence suggests we should assess and eradicate the risk factors causing the pain or ideally assess the risk factors prior to development of pain or injury, so that preventative measures can be put into action.

That’s why at the Chiropractic Network, Warwick we provide the public service of a complimentary private consultation to allow correct assessment of these risk factors in the development of pain.

This consists of:

• A full past medical history.
• A thorough examination including Orthopaedic, Neurological, Postural, Gait and Bite assessment.
• Referral for X-rays or an MRI scan if required.

You’ll then receive:

• A Diagnosis and Prognosis of your complaint.
• Specific advice, or rehabilitative exercise prescription should we feel no further management is required.
• An explanation of our treatment protocols, should we deem treatment necessary.
• Referral to an appropriate specialist should we deem them more appropriate for the management of your case.

Very often this service can prove of huge benefit to the quality of peoples lives, allowing them pain relief, prevention of further injury, and improved quality of life. For further information, or to book a consultation appointment please don’t hesitate to contact the clinic via the number provided: 01926 498 700. I look forward to helping you soon.

Dr. Oliver Hobkirk-Smith MChiro (AECC) DC (Doctor of Chiropractic) CH Dip. C. Hyp

Researching back pain

The team members of CORE Physiatry are embarking on new research projects which have come about from the current advances made by the past research.

We are proud to announce that funding is now being sought for this research and have already managed to raise some funds for this novel but beautifully simple research project.

The long-term project looks at assessing the multiple causes of back pain, their efficient assessment and categorisation and ultimately will help to point to best-treatment protocols in back pain care.

We look forward to keeping you posted on our progress over the next few years!

Stefaan, Oliver and the team

We are pleased to report our outcome statistics for the year 2010 to-date:

99.6% (279 out of 280) of patients who were offered and followed treatment following their free initial examination reported as good as or better results than they were told they could achieve after the examination.

By integrating the best in gait and malocclusion (walking and biting) care and management together with extensive expertise and experience in spinal care and rehabilitation we have been able to achieve excellent results for people suffering from back pain and back-related problems.

Our clinic’s focus is dedicated to continuing the delivery of the best care for back pain and spinal injuries and pursue excellence whilst remaining affordable.

The average duration of symptoms prior to presentation to the clinic is:7.2 years. The average cost is: £320. Simpler, more recent injuries and problems are cheaper and faster to recover than chronic problems.

Feel free to contact us for any further information.