--Dr Gaurav Raj Dhakal
Four out of five adults will experience back pain in their life time. Fortunately, majority of the pain will subside in a few weeks. PAIN is a complex experience that includes both physical and psychological factors. It is quite normal to have emotional reactions to back pain such as fear, anxiety, and nature of pain, how long will it last, and to what extent it will affect one’s daily activities.
To minimize emotional distress, it is important that you seek a spine surgeon’s consultation and ask questions about your back. Understanding your pain will help decrease your anxiety. If your pain last for more than three months then, it becomes chronic in nature. Any chronic pain is associated with a greater amount of psychological distress.
Remember that there is a dynamic relationship between your stress level and your pain. Pain causes stress which causes more pain which in turn causes more stress. Stress leads to loss of sleep, inability to work, irritability and a sense of helplessness.
The management of back pain needs a holistic approach. It involves visiting a spine surgeon at the onset of back pain. The spine surgeon after evaluating your back pain will try to address your fears and misconceptions about back pain. A reasonable explanation regarding the cause of the pain will be provided. The patient will be encouraged to resume activities of daily living and also get back to work. A course of graded physiotherapy, analgesics will be prescribed.
As a patient it is important that you express your concerns about your pain symptoms. Your spine surgeon should fully explain what is being looked or ruled out during evaluation and tests. You should inform the doctor about any functional difficulties you are experiencing due to the pain. And most important is that the information you receive should be clear to you.
A number of psychological therapies are successfully used in the management of pain and anxiety. Modalities such as stress management, relaxation training, biofeedback and cognitive behavioral therapy are often used. Medications to help with sleep problems, anxiety and depression are often prescribed in consultation with a psychiatrist. Such comprehensive pain management programmes in integration with back care have proved to be successful.
The spine surgeon may refer you to a psychiatrist but it does not mean that the pain is “all in your head”. It is meant to have a holistic approach in the management of back pain. Remember, pain is a complex experience that includes a close interaction of physical and psychological factors! You, your spine surgeon and a psychiatrist can help you manage and overcome your back pain and emotional distress!
The author is a Spine Surgeon associated with Norvic Spine Clinic and is a Fellow of the Association of Spine Surgeons of India. For more information please write to us at [email protected]