Low back pain (LBP) is a common issue affecting millions globally. However, while many people experience LBP at some point, only a small percentage develop chronic pain. Staying informed about your condition, avoiding fear-based responses, and taking proactive steps can significantly reduce your risk of LBP becoming chronic. Here’s how.
1. Understanding the Condition: Education as a Prevention Tool
Patient education is crucial in preventing the chronicity of low back pain. Understanding that LBP doesn’t always signal severe injury and that it can often improve naturally helps patients maintain a positive mindset. The knowledge that LBP can resolve on its own is empowering, enabling patients to take control over their recovery.
Educating patients about the typical causes and course of LBP is essential to build confidence in managing it. Studies suggest that educating patients about their pain reduces the fear of movement, improves outcomes, and can be more effective than many other interventions .
2. Reassurance: LBP Without Neurological Involvement is Rarely Dangerous
A key aspect of managing acute LBP is reassurance. The majority of LBP cases are musculoskeletal, meaning they don’t involve significant nerve or spinal damage. As long as there’s no severe neurological impairment — like loss of muscle strength, nerve compression, or significant changes in sensation — LBP is generally not dangerous.
Only a small subset of patients with LBP will need surgical intervention. Surgery is typically considered when nerve compression results in severe sensory or motor deficits that impair quality of life or functionality. In fact, statistics show that only a tiny fraction of LBP patients undergo surgery .
3. Recognizing and Addressing Chronicity Factors
Chronic low back pain is typically defined as pain lasting longer than three months. Globally, chronic LBP is often linked to psychological factors like fear of movement and poor understanding of the condition. When patients avoid movement due to fear, it reduces tissue stimulation, including that of the nervous system, leading to a phenomenon known as “pain snowballing,” where pain perception increases over time.
Encouraging safe movement and correcting misconceptions about LBP can help patients avoid chronic pain. Studies have shown that addressing movement fear and promoting physical activity helps “retrain” the brain and nervous system, reducing pain perception and improving long-term outcomes .
References
1. Van Middelkoop M, Rubinstein SM, Kuijpers T, Verhagen AP, Ostelo R, Koes BW, van Tulder MW. A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain. Eur Spine J. 2011 Jan;20(1):19-39. doi: 10.1007/s00586-010-1518-3. Epub 2010 Jul 18. PMID: 20640863; PMCID: PMC3036018.
2. JJavier Martinez-Calderon, Mar Flores-Cortes, Jose Miguel Morales-Asencio, Alejandro Luque-Suarez, Pain-Related Fear, Pain Intensity and Function in Individuals With Chronic Musculoskeletal Pain: A Systematic Review and Meta-Analysis,The Journal of Pain,Volume 20, Issue 12, 2019, Pages 1394-1415, ISSN 1526-5900.
3. Evans L, O'Donohoe T, Morokoff A, Drummond K. The role of spinal surgery in the treatment of low back pain. Med J Aust. 2023 Jan 16;218(1):40-45. doi: 10.5694/mja2.51788. Epub 2022 Dec 11. PMID: 36502448; PMCID: PMC10107811.
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