Back Pain Clinic Principle 4 – “Movement is life”
A case study…
I’m reminded of a woman I went to see in her home about 25 years ago. I’d been an osteopath in Edinburgh for only 2 years then. She had severe lower back pain with pain down the front of her thigh as far as her knee (sciatica goes down the back of your thigh, not the front). She had been in her bed due to the pain for 4 weeks. Only leaving her bed to use the portable toilet next to her bed. Actually that isn’t entirely true. She had been her bed because a consultant Orthopaedic surgeon at the local private hospital had recommended this course of action. Or should I say inaction.
Prior to that she’d been struggling on. Since taking to her bed she had lost her appetite, lost some weight, lost all zest for life and become constipated, dependent on laxatives and depressed. Her pain had also increased, along with the increasing amounts and varieties of medication she was on.
What advice to offer her?
What to do? It was simple. I asked her husband and son to move a single bed into the living room on the ground floor. I helped her to see that total rest was in fact making her pain worse. And that if she carried on in this way it seemed unlikely that she would recover any sort of normal life. She was only 61 years old. I also encouraged her to do some very minimal movements. Movements that didn’t hurt. Initially that was very little, just moving her legs up and down in the bed. I also encouraged her to start contracting and relaxing her pelvic floor muscles (which activated her abdominal muscles a little too). She committed to get out of bed and walk around the room with a walking stick at least every hour.
I called her after 4 days. She reported that although she still couldn’t sit due to the pain, she was feeling 50% better and was exceptionally grateful for all that I’d done. I pointed out to her that as she’d been in so much pain I had done nothing to her. I had merely helped her to see that she needed to move.
How does Back Pain Clinic Principle 4 work?
Remember from Principle 3 that your body can heal itself. However, to heal itself it needs certain conditions. It needs adequate nutrition, and rest and movement. The first two may be obvious, but the third is just as important. Without movement any inflammation that is present tends to build up. This is often why your pain is worse first thing in the morning… Lack of movement leads to an increase in swelling locally. Movement brings fresh blood into the area and washes out the old venous blood and lymph fluid, taking with it the inflammatory fluid. This fresh blood and tissue fluid is full of nutrients – oxygen, glucose, hormones and other chemicals essential to healing.
Without movement your muscles weaken and waste very quickly. This probably accounted for the lady’s weight loss. She was actually losing muscle mass due to lack of stimulation and demands. Even if your pain does lessen, the loss of muscle mass and conditioning significantly increases the risk you’ll have another bout of back pain within 12 months.
Movement is absolutely vital to good mood too. If you want to feel depressed, try lying around in your bed for days. On your own. Depression increases your perception of pain. That’s no help is it?
Remember my Number 1 rule (not the same as Principle No. 1)? “Use it or lose it, but don’t abuse it“. The use it or lose it bit is all about the importance of maintaining movement in order that you don’t ultimately lose capacity. The movements that you can do without aggravating your pain may seem small and insignificant. But I promise you, they are worth doing. Any movement that doesn’t hurt is worth doing. You will heal more quickly and more fully if you adopt this approach.
If you’d like tailored help in-person or via skype consultation, or to see “an osteopath near me“, book an appointment with an Edinburgh osteopath. Or call us on 0131 221 1415 to arrange to see one of the team.