It usually makes things easier and more simple to have a scapegoat. One place to throw all the blame. But how often is one person or event entirely to blame for a result?
In the case of pain, it’s rarely that easy. As a spine guy, I’m specifically focused on pain originating from the spine when I make that previous statement.
Pain originating from the spine, which is what I mean when I say pain from now on, is the result of exceeding the pain threshold. Understanding the pain threshold (the point at which you perceive pain), is critical if we want to understand how to decrease our pain.
The pain threshold: let’s start with an analogy
We’re going to take it back to the old days. Think about an invading army trying to break through the large wooden gates of a castle.
There are a lot of factors that contribute to when that gate is going to finally give way. The strength and material of the door and other structural reinforcements, the strength of the battering ram, the force behind the battering ram, etc, and even these factors are affected by several other factors. Lots to consider!
This is similar to how the pain threshold works. It’s usually not so dramatic or intimidating as a battle, but our tissues can take several impacts from the “battering ram” before we experience pain.
With my patients, these impacts from the battering ram are what we call triggers, which we talk about constantly! It requires several sub-threshold triggers to surpass the pain threshold leading to the experience of pain.
The pain threshold: a specific example with low back pain
Let’s bring this pain threshold discussion to the real world for an example.
My example patient, a middle-aged female, has been dealing with low back pain for two years. She’s tried tons of different treatments with different practitioners but never experienced any lasting change.
Everyone she’s seen so far tries to blame her pain entirely on weak glutes, or they simply say she’s getting old and this is just what happens with age.
Remember the scapegoat trap we talked about in the beginning? It’s easy, but usually very wrong.
Her experience of pain is much more involved than weak glutes or simply age. Her low back pain is a result of many triggers throughout the day, but she doesn’t experience her pain until late in the morning most days.
She triggers her spine injury when she gets out of bed first thing in the morning, puts on her pants and socks and shoes, picks up the toys from her kids, when she vacuums, gets down and up from her chair at breakfast, gets in and out of her car, and how she sits in her car.
She sits at work for about forty minutes in her office chair and starts to feel the pain coming on. Since she feels the pain about the same time every day, she thinks her office chair is to blame.
But this is the beauty of understanding the pain threshold. It’s the culmination of incorrect movements all morning, movements she didn’t even feel as painful, that build up until she finally passes the threshold and experiences the pain.
Sitting in her office chair is only the final trigger that nudges the gate open, leading to the experience of pain.
Triggers: identify and remove
So how do we help someone like our friend we’ve just met? We identify her triggers and remove them. This is our expertise.
We teach her how to stabilize her spine more effectively, then we help her apply that new skill into all aspects of her day. We show her how to get up from lying down, get in and out of her chair, how to sit, how to drive, how to vacuum, how to open a door, etc.
We’re picky and relentless in these matters because we understand the pain threshold. We know that if you can stop the hundreds of impacts from the little battering rams throughout your day, your gate will stand strong and you won’t experience pain.
Conclusion
This all may sound too simple, but our focus on removing triggers makes all the difference. This is what allows us to be effective and fast in getting patients out of pain.
I want every person with back pain to understand how important the common, everyday movements are in overcoming your pain. This knowledge empowers you to be the agent of change that leads to lasting healing.
Find an expert clinician that helps you identify and remove your triggers; a clinician that empowers you with the knowledge and opportunity to overcome pain through your daily actions.
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