New study shows complexities of psychology and pain
If you're struggling with a bad back today, new Australian research might have some interesting findings for you.
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00:00 This is below back pain, which is below your rib cage and above your buttocks, but may
00:07 or may not be going down your leg.
00:09 The real question addressed by this research was, if you've got acute low back pain or
00:15 grumbling low back pain that's not making you scream in pain or persistent pain, what's
00:22 the chances that you're going to get better from that?
00:25 And they studied, they brought together the evidence from about 20-odd thousand people,
00:29 so it's a big study reviewing the evidence.
00:32 And what they showed was that if you've got acute back pain, it comes on fairly suddenly,
00:36 really severe in your back, really severe in your back, and you're really in agony,
00:42 most people will get better within six weeks, no matter what you do.
00:46 In fact, you can make it worse by lying down to it, but if you just do what your doctor
00:49 says and keep moving around, 70% of people will have pretty low levels of pain at six
00:54 weeks.
00:55 And of the people who remain, the 30% remain, 70% of those will be better by six months,
01:02 by three months, sorry, not six months, three months.
01:04 And the same goes, you wake up one morning and your back's sore, but it's not like screaming
01:09 in agony, what they call subacute pain, same goes.
01:13 Most people will be better within six weeks, and of those, most of those left over at six
01:19 weeks will be better by 12 weeks.
01:21 So that's really good news.
01:23 Those with persistent pain, though, whose pain goes on for three months, those are the
01:27 people where it just seems to linger and not go away.
01:32 And so what this tells you is that you can be reassured when you've got acute low back
01:36 pain that the chances are you're going to get better, either six weeks or 12 weeks,
01:41 same with grumbling pain.
01:42 The real question is persistent pain, which is the minority of people, and what do you
01:47 do about that?
01:48 And what the research, these are research at the University of South Australia who've
01:51 long been studying low back pain.
01:54 And one of the problems they think people have to confront is that when you get acute
01:58 low back pain, you think you've thrown something out, you know, you've slipped a disc or something
02:03 like that.
02:04 Now, some people have prolapsed a disc, but that's rare.
02:08 And that's an emergency, actually.
02:10 So you're limping, you're dragging your leg, or you're numb between the legs, or you can't
02:15 pass water.
02:16 That's a surgical emergency where you may well need to have lumbar surgery to actually
02:21 relieve the disc pain, but that is incredibly rare.
02:25 Most people, it's pain.
02:27 And there's not much evidence that you've thrown anything out.
02:30 Something's happened, and it probably varies between people what it is.
02:34 And whether you go on to persistent pain often is how the pain is framed for you.
02:39 So if you go and see a doctor and the doctor says, "No, no, no, this is really bad.
02:42 You've got to lie down to it.
02:43 It's not going to be good news, blah, blah, blah."
02:45 Then you are more likely to have a chronic pain pathway than other people where the doctor
02:52 is sympathetic and says, "This is a time-limited thing.
02:56 You're going to get better.
02:58 You will get better."
02:59 And this is where it's not as if the pain is all in your head or your nuts or something
03:03 like that.
03:04 It's more that pain is a very complicated process involving your brain, your thinking,
03:09 your mood, and so on.
03:10 And the University of South Australia, they've developed treatments.
03:14 And they also have at the University of Sydney, which are partly psychological treatments
03:19 to help people get over that barrier which reframes the pain.
03:23 It doesn't get rid of the pain, but it helps you deal with it.
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