What is the cause of a sore back?
A lot of our understanding of lower back pain (and indeed all pain in
the most general sense) came from the work of two scientists called
Ronald Melzack and Patrick Wall. They received the Nobel Prize for their
work on pain and were the first to write about what they called the
"gate theory of pain." This concept is often referred to as the Pain
Gate and - like all great scientists they were able to take a
complicated idea and make it seem very simple.
Melzack and Wall realised that it wasn't only the pain messages coming into the brain that were important. What the brain did with them when they got there was the key to how much pain was experienced. This concept is extremely important in trying to understand lower back pain - chronic lower back pain in particular.
They noticed that pain severity varied depending on what else the body was doing at the same time. In other words the brain could be distracted away from "listening" to the painful area if it was busy doing something else. This is the way that pain treatments like hypnosis work and also why soldiers don't feel pain in the heat of the battle.
The spinal cord can do this too. The spinal cord prefers to deal with one thing at a time and other signals from the body can distract it and shut the gate on pain if they arrive at the same time. This seems to completely or partially stop the pain signal from getting to the brain.
But can any other kind of bodily signals can do this "pain gate"
trick? Well, strangely, it seems that other pain messages can.
Long ago our ancestors realised that one way to get rid of a pain was to give the sufferer another pain somewhere else. You would quickly forget about a headache if you accidentally put your hand in scalding hot water. Melzack and Wall realised that the "other pain" didn't need to be quite as dramatic as that. In fact even the merest hint of discomfort from another source is enough to help close the gate on pain. This is one of the ways acupuncture works for lower back pain. Old fashioned remedies like mustard poultices and hot or irritant rubs do the same and are still used by many back pain sufferers today.
The spinal cord responds to touch messages by closing the pain gate and this fact is what lies behind something we all do instictively - rubbing it better. TENS machines work this way and you can read more about this in the section on acupuncture and TENS elsewhere on this website.
More on the Pain Gate
Is all this clear so far? We've looked at the body stimuli which can help to close the gate on pain and make lower back pain less unpleasant for us. These include:
• mental things - like keeping occupied or concentrating hard on something else and
• skin things - like touch or other more uncomfortable sensations.
But what about the opposite situation? Can the pain gate be opened and our pain situation made worse?
Yes it can! And the biggest culprit is a chemical within our bodies called adrenaline.
Now adrenaline in small amounts is useful to us. It's what keeps us buzzing around doing our day to day chores. It even has the ability to reduce pain if we get a sudden surge of it from time to time. That's how sportsmen and soldiers can seemingly not feel pain in the heat of battle. But adrenaline is a two edged sword. If we get too much then it has the effect of keeping the pain gate open and of making pain messages seem stronger to the brain.
How do we get too much adrenaline. Mainly by becoming stressed or by having negative thoughts. Fear encourages the body to make huge amounts of the stuff.
Some new clinics - called pain management groups - are making use of this information to help people get better from chronic lower back pain or other long term pain situations. They start off by teaching people about their own bodies and the way they work. They then teach how pain comes about and where it comes from.
We know that fear is often due to not knowing the truth and therefore
imagining the worst. If you know the facts then you have less to fear.
Stress makes adrenaline circulate in large quantities. Relaxation exercises reduce stress and help the body cut down on the amount of adrenaline in the circulation.
Pain Management Groups help people become aware of the way their own thoughts work and the effect mood has on pain. All of this switches off the system and closes the gate on their lower back pain. The results can be spectacular, even for those who have been in pain for years.
This website can't take the place of such clinics but it should help you to move in the same direction. As you read and learn more about your lower back and how it works you will come to fear your lower back pain less. With less fear comes the power to get control of the situation and to live a normal life again.