Positive Health Online

Feeling in control makes us happy. We all like to know that it’s our decision what we eat, what we do in our spare time, what job we do, and generally how we live our lives. We feel better about ourselves and we gain a high level of satisfaction and enjoyment from knowing that we have made the decision to do the things we’re doing.

Equally, when we perceive we are losing control, it makes us feel anxious, stressed, depressed and helpless.

What does this have to do with Back Pain?

According to The Lancet, back pain is the number one cause of human disability and is something that can make you feel completely out of control.[1]

This is because back pain is not just about the obvious physical symptoms: it can also have significant social and emotional consequences. As a physiotherapist, I’ve seen first-hand the psychosocial effects that back pain can have on people. It can stop them enjoying life, it hinders their ability to do activities they enjoy, from gardening and dog walking, to exercise and travel. It disrupts sleep, causes absence from work, and affects social life and family time.

So it’s unsurprising that people who suffer with back pain, especially chronic, long-term or recurring symptoms, can increasingly experience anxiety, depression, irritability, isolation and helplessness, as well as a growing fear of physical deterioration. They feel they no longer have any control over their pain or the way they are feeling.

How do people with back pain compensate for this loss of control? They try to control the circumstances around them, and one of the main areas they focus on is activity.

Their thought pattern goes like this:

They therefore draw the conclusion that:

But this is a bogus conclusion. In fact, what less activity really means is that their lower backs will be in a worse physical condition. And:

This is why modern back pain treatments are increasingly focusing on getting patients to become more active. But the question for those who have back pain is: How can I become more active when I have back pain to start with?

Control is Power

The recent report in The Lancet recommends that Cognitive Behavioural Therapy (CBT) becomes a first line treatment within the NHS in the UK.[2] I use this with some of my patients, and it can be very effective.

For example, as a hands-on, manual physiotherapist, I use some treatments which can cause the patient to experience a high amount of pain. Despite this, most of the time they can be calmly telling me about what they did at the weekend. This is because they’ve conditioned their thoughts to produce self-talk like: “I am in safe hands, this pain is natural, this pain is doing me good, everything is in control.” This creates in the patient emotions of calm, ease and relaxation.

However, say that the same patient is walking down the street and experiences that exact same level of pain – but this time without knowing the cause. Their self-talk would then become more negative and may be something like: “I don’t know what this is, it might be something serious, what if it never goes away, I have no control over this.” This would then create emotions of worry, fear, powerlessness and a lack of control.

Because the body is a chemical factory and is always pumping out hormones in response to our moods, back pain sufferers who are relaxed will start to get better as their bodies release dopamine and melatonin. These hormones promote healing and calmness.

Conversely, the bodies of patients who are fearful will release adrenalin and cortisol, which increase inflammation, muscle tightness and tissue breakdown.

This illustrates how:

Take Back Control – and it Will Ease the Pain

There are huge benefits to changing how a patient perceives their pain and the control that they have to relieve their pain.

I am convinced that the key to combating both the physical and psychosocial effects of back pain is to enable people to feel in control. Give them control over their pain, and it will promote all the benefits I’ve just discussed. In short:

In treating my patients for lower back pain, I knew that if I could help them to get on with their lives in between waiting for consultations with myself and other therapists, it would give them the feeling of control and have the knock-on effects that would lead to healing.

Pelvipro

I knew from my clinical experience that realignment had a positive effect on my patients. By ‘realignment’ I mean making sure that the pelvis is straight and not being pulled to one side or the other, and that the patterns of movement around the lumbo-pelvic-femoral region are correct. I believe that a key cause of lower back pain is a misalignment or asymmetry of the pelvis in relation to the spine and hips.

I perform the realignment process on most of my back pain patients at the beginning of every appointment, as the basis for further treatment. Often, this process gives the patient some immediate form of pain relief.

This led me to wonder if there was some way I could help patients to perform this process themselves whenever they needed to, handing back to them not just the physical relief provided but, crucially, CONTROL over their pain.

After a long time researching and developing ideas, I launched Pelvipro, a simple-to-use, portable device that works by correcting a misalignment of the spine and pelvis which, in turn, strengthens muscles and heals damaged tissue. Because it is portable, Pelvipro enables people to control their pain on their own, at any time and wherever they are: at home, at work or even on holiday.

The Pelvipro in use to relieve lower back pain

The recent Lancet article strongly recommends patient self-management.[1, 2, 3] Pelvipro well and truly ticks this box. When in pain, the body adopts common patterns of movement which, ironically, cause more aggravation of bodily tissue, causing more pain and keeping the patient in that same pattern of movement. Pelvipro puts the body in a more optimal pattern of movement, which instantly takes the strain off the body tissue. Pain relief can be felt instantly. In trials, 95% of people experienced an instant relief from pain directly after using the Pelvipro, while 95% of people improved on their “ability to fulfil routine tasks” and 90% showed an improvement in their disrupted sleep.

But our trials also showed that using Pelvipro led to marked psychological benefits for patients, because it enabled them to create this positive effect themselves and it put them in CONTROL of their pain. Our trials showed:

• 92% of patients trialled were able to partake more in the activities they enjoyed doing; They classed many of these activities as “exercise-related” or “hobby-related”;
• 95% improved in their stress levels or anxiety;
• 84% improved in their fear of back pain and loss of hope levels.

Having Pelvipro on hand 24/7 gives the patient that all-important control over their pain. This gives them the confidence and ability to go out and undertake the activities they want to do. In turn, this builds strength and conditioning. The patient no longer has the nagging pain that leads to fear about doing harm to their body. The beauty is that it trains the body into the correct pattern of movement, so patients end up using it less and less. Many people who have been using Pelvipro for a while now only need to use it once a week to ensure optimal positioning. But it also acts like an asthma inhaler, in that when you get an attack you use it for relief. With Pelvipro, when people start feeling familiar pains in their back, they reach for Pelvipro to prevent the pain producing patterning.

Pelvipro is now helping people with a range of lower back conditions, including:

• Lumbar strain or sprain;
• Sciatica;
• Degenerative process of disc or facets;
• Herniated disc;
• Spinal Stenosis;
• Sacroiliac joint dysfunction;
• Facet joint stiffness;
• Scoliosis;
• Spondylolysis;
• Presumed instability.

As more and more people discover Pelvipro, many are using it as part of a combined approach to treating their lower back pain, ensuring their back is in its optimal position for exercise, sport, Pilates and yoga.

Pelvipro is not just a money-making device claiming to relieve lower back pain. It has been developed using my clinical experience and evidence-based techniques, and it has been shown in trials to be highly effective not just in relieving the physical symptoms of lower back problems, but also the psychosocial effects of back pain by helping individuals take control.

References and Bibliography

1.         Clark S and Horton R. Low Back Pain: A Major Global Challenge. 21 March 2018.

2.         Prof Nadine E Foster, DPhil, Prof Johannes R Anema, PhD, Dan Cherkin, PhD, Prof Roger Chou, PhD, Prof Steven P Cohen, MD, Prof Douglas P Gross, PhD, Paulo H Ferreira, PhD, Julie M Fritz, PhD, Prof Bart W Koes, PhD, Prof Wilco Peul, PhD, Prof Judith A Turner, PhD, Prof Chris G Maher, PhD. Prevention and Treatment of Low Back Pain: Evidence, Challenges, and Promising Directions. 21 March 2018.

3.         Prof Rachelle Buchbinder, PhD , Prof Maurits van Tulder, PhD, Prof Birgitta Öberg, PhD, Lucíola Menezes Costa, PhD, Prof Anthony Woolf, FRCP, Mark Schoene, BS, Prof Peter Croft, MD. Low Back Pain: A Call for Action. 21 March 2018.