Back pain, core stability and education

Over at The Sports Physio Adam had a great post reviewing the research out there on the use of core stability exercises in dealing with chronic back pain. The review comes to the conclusion that there is little to be gained from the use of core stability exercises specifically over a more general approach to exercise and other forms of physiotherapy treatment.

In this study in the US military it was shown that out of the three groups tested it was those who received material, in the form of a one off 45 lecture/Q & A session, educating them about pain that had the best long term outcomes.

In this paper they examine the use of language, metaphors in particular, in the treatment of people with chronic pain. The study showed that whilst they were useful they were, understandably, open to misinterpretation. It highlighted the need to work with the patient in order to come up with language that creates the correct,positive picture to aid in a beneficial outcome.

So much about the cause of chronic pain is misunderstood or not understood at all. It is often tied up with previous experiences and how you think what you do now will impact on you. There is little good evidence about what type of treatment is best and, as much of the pain experience is tied up with the psychological aspects of how we perceive pain, it can be as important what kind of relationship you have with whoever is treating you as much as what approach they are using. If you trust the therapist and they empower you in a way  that you no longer fear those activities that you feel cause the pain to flare up you are probably a long way towards sorting the problem out.

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