By Elsie Hibbert

Persistent low back pain can affect people in many different ways – it can range from an intermittent mild stiffness, to acute severe pain and everything in between. While physiotherapy is useful to treat acute episodes of low back pain, and work with you to reduce the risk of reoccurrence, implementing self-directed management strategies is also an integral piece of the puzzle in addressing long-term low back pain. While there is no one magic fix, empowering yourself to manage your pain is the first step in reducing what can often feel like a daily struggle. Here’s your self-management checklist:

Are you moving/changing positions regularly?
While there is not one inherently “bad” posture for the back, low back pain can be exacerbated when long periods of time are spent in one position. Some examples include, long periods of driving, office work, road cycling, or even long periods of standing on hard surfaces. Changing your posture and position regularly may help to prevent a flare of your back pain. This can include adaptations to your car seat or desk chair, seated low back stretches, or setting phone reminders to move regularly.

Are you getting enough sleep?
Sleep is important for many reasons, including recovery, stress management and overall energy. Being in pain can often cause reduction in sleep quality. While this may not be something you feel you can control, it may be important to focus on the things you can control – practice good sleep strategies such as setting a routine, reducing screen time, and avoiding caffeine or sugary foods in the few hour leading up to bedtime.

Do you have a regular exercise routine?
Yes, exercise is important for chronic low back pain. Exercise can help to not only make you stronger and more flexible, but it also improves sleep, reduces stress and assists with weight control. The most useful exercise is the exercise which gets done – so try to choose something you enjoy, such as walking outside, or yoga. If you are struggling to figure out an exercise routine which does not exacerbate your back pain – it may be useful to consult with your physio to figure out an appropriate plan for you.

Are your stress levels managed?
Stress can contribute to pain in multiple ways; the heightened sense of stress can result in increased sensitivity and alertness to sensory stimuli, including those which cause pain. Stress management can come in many different forms for people from simple relaxation and breathing techniques, to increasing social networks for others.

Do you wear supportive footwear?
This is something to think about when trying to manage your low back pain. If you are on your feet a lot throughout the day, regular use of high heels, or unsupportive shoes could contribute to exacerbating your pain. You may find benefit from wearing more supportive shoes throughout your day.

Have you tried heat?
If you are experiencing pain in the moment, it can be beneficial to try a heat pack with some gentle mobility to help you find some relief. Heat is often the modality of choice over ice (however, if ice works for you then go for it!).

Have you educated yourself?
It can be important to do your own research on chronic low back pain in order to try to understand it better – after all, knowledge is power. Chronic low back pain is a complex, multi-faceted condition, there are many factors which can play into your pain. In most cases, low back pain is not a result damage or harm, and moving and using your back does not put it at risk of damaging anything. In fact, it is often the lack of movement resulting from fear around back pain which can contribute to more exacerbations! It is important to know the evidence to guide your self-management. It’s also important to make sure your information is coming from a reputable source!

Do you have good supports?
In the way of supportive family and friends, as well as a health care provider if appropriate. If you are really struggling with your back pain, it is important to talk about it. Additionally, it is important to find health care providers who listen to you, and are there to work with you to determine the best treatment approach for your lifestyle.

Here at Carlton Physio our philosophy is to make sure those we see with chronic back pain are supported towards a self management strategy that works for them. Everyone’s treatment plan will be individualised to meet their personal requirements. Our treatments will focus across three pillars, optimising movement, minimising pain and long term strategies. This will most likely look like a combination of hands on treatment, mobility and strength based exercises and ongoing education. For some this might mean a short burst of appointments to get you started on your way, for others we might see you less frequently but over a longer period of time. Ideally, after an initial round of treatment, you then have your physio there as a back up if things get off track (as we all know life does). Our aim is for you to be empowered by understanding more about your condition and how it behaves, allowing you to do more with less reliance on others.

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