Resources for People with Back Pain
Pain can be pretty complicated. Here are some examples of similar systems which may help explain it.
Alarms are installed to protect cars, and we have a pain system for very similar reasons. Pain helps to protect you from danger. How sensitive an alarm you put in your car depends on how much your car is worth to you and how dangerous are the places you leave it. Your body, and particularly your back, head, and genitals are worth a lot to you so the body has very sensitive alarm systems in these regions (pain).
Because your car alarm is designed to protect your car from damage or theft, it is set to be activated before damage occurs. This mean that it might alarm when a heavy truck drives past, or it gets moved by the wind, or someone brushes past it. This can be pretty frustrating if you are living on the same street as someone with a car alarm that goes off every time a cat walks past. It is also difficult for the owner to tell whether the alarm means the local tom is prowling or the wing-mirror has been knocked off.
When you leave your car somewhere safe, like your garage, you may not bother to turn the alarm on. This means that if someone manages to slip into your garage, they could inflict all sorts of damage on your car without the alarm going off. Thankfully, your pain system is on whenever you are conscious (including when you sleep), so you cannot damage yourself without noticing.
Regardless of whether or not you turn on your car alarm at home, you are much more likely to turn it on if you are parking on a street that you think is a bit dodgy. Similarly, if you are doing something with your back that you think is dangerous or risky (see Myths about backs), the alarm will become more sensitive, that is, the alarm will be activated more easily. This means you are more likely to get pain even if no damage has occurred.
There are a few differences between alarms in backs and the cars. The first is that it’s pretty easy to check the car for damage after the alarm has gone off, but it’s almost impossible to look into your back to see whether there is any damage. On the other hand, you usually know what your back has been doing in the moments before it starts to hurt, whereas you might not have any idea you’re your car alarm has gone off. This means that unless you have been hit by a train, it is a pretty good guess that if there is any damage (keeping in mind that there might not be any damage at all), it’s more likely to be on the wing mirror end of the spectrum than a complete write off. This means that it’s still quite safe to use and move your back. It’s a bit like if you have parked your car on a dodgy street where someone has knocked off the wing mirror. The car is still safe to drive and it’s probably a good idea to move it.
If you are unsure about how safe it is to move your back, you can always try moving a bit and see what happens, or you can go and see a health professional and get their opinion.
The final difference between backs and cars is that cars need to be repaired when they are broken whereas backs are very good at healing themselves.
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Meerkat sentries look out for danger while the rest of the clan graze for food. They give a warning bark to the clan before a predator gets close, so that the clan can find safety. The nervous system works in the same way. Nerve receptors in the back look out for things that could be dangerous and send warning messages to your brain.
Pain is a warning bark that means the nervous system has decided that attention should be paid to something. It does not say that an injury has occurred. Often the best response is to look more closely at the source of danger - it might only be the breeze moving the grass. Because most people know someone who has had a lot of problems with their back, the nervous system will tend to bark much more quickly when it thinks that danger might be approaching the back than it will do with similar danger elsewhere in the body. But this sort of over-reaction is often not helpful. If the whole meerkat tribe hides every time the breeze moves the grass, they'll never get fed!
The receptors in the back can become over-active. This is like a scaredy kat that that barks without any real danger and won't let anyone out of their burrows because he's afraid that a predator might approach without him noticing. This kat needs to be taught that the danger is not as ever present as he thinks it is. The clan may need to ignore him and get on with eating. Fear can also be contagious; imagine what would happen if all the meerkats started looking for danger, there'd be none left to find food.
Over-active sensors in the back also need to be taught to calm down. Gradually exposing them to more movement is a good way of doing this.
Nerve sensors in the back can also be thought of like a computer USB mouse. When you click the mouse button an electrical signal is sent along the cable to the computer. What this signal means, however, is entirely dependent upon what the pointer is hovering over on the computer screen. It might say Save, it might say Send, it might say Download, or it might say Delete.
The meaning of the electrical signals coming from the nerve receptors in the back is also entirely dependent on what is going on in the brain. If someone is angry or stressed, the brain will see the signals as being more dangerous, and will be more likely to make pain. If someone is happy or doing something else which is more important, the brain will be less likely to make pain.
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There are sensors which detect wave movement throughtout the oceans. When these sensors move more than normal, they send a signal to Civil Defence. Civil Defence correlate this information with, signals from other sensors, and everything else they know about what is going on (i.e. a recent earthquake, or a storm in the area). If they decide that there is a danger that a tsunami may be coming our way, they activate the tsunami warning system. This warning system doesn't say we've been hit by a tsumami, or even that we will be. It just says that there is a risk to which we should pay attention.
What a tsunami siren means to you will depend upon your own circumstances and experiences. If you live on the coast it will mean more than if you live on a hill. If you've previously experienced a tsunami, or known someone who has, it will also mean more to you. If you were expecting a siren you will react more quickly than if you were not.
When information arrives at the brain from sensors in the back, it is also combined with other information from the area, and everything else the brain knows about what is going on. If it decides that there is a danger and the person should pay attention to this, it makes pain.
After recent tsunami in Aceh, Samoa, and Japan our warning systems are much better than they were in the past. We are now much safer, but we get a lot more false alarms. After you someone has had back pain, it is also likely that their nervous system will be more protective of their back. This means that they'll get more back pain when their back is not actually in danger.
“People do have to have a knowledge of why pain’s there, and how anxiety and your head can make it worse, to be able to overcome it, and move forward really”
BRIDGET, 65 YEAR OLD WOMAN
Have you noticed that your urge to empty your bladder can be stronger when you are nervous? Have you ever thought you heard your phone ring when expecting a call? Pain can also vary based on what else is going on in your life.
Normally when something hurts you can look at the body part to see what is causing the pain. You cannot do this with your back. This can make you worry.
When you are angry, worried, or stressed, the brain sees the back problem as being worse, so it makes more pain. This does not mean that your back is more injured.
You do not have direct control over your brain’s choice to make more or less pain. You can influence how you view and react to these changes in pain.
Backs have a bad reputation. People often expect back pain to be serious and long term. However, most people make a good recovery.
Sometimes it takes a while for pain to settle. This does not mean that you are not healing. It just says that your nervous system is still protecting your back.