Kelly Marshall is a renowned personal trainer and owner of the Body Project. Approximately 50% of the patients she sees suffer from back pain. Another 30% suffer from neck pain. Kelly believes in a multifaceted treatment approach to help clients recover from chronic back pain, because the entire body is interconnected. She also believes approximately 85% of people with back pain can make full recoveries. Armand Brevig talked to Kelly recently to explore what’s behind this belief and what the secrets to recovery are.
Back pain – symptom or condition?
Armand: Given that back pain is THE leading cause of disability in most western countries, how could an 85% recovery rate ever be possible?
Kelly: In my view approximately 85% if all back pain represents symptoms, rather than conditions. So, in typical lower back pain something else is causing the pain. Once you address that root cause, the pain will go away.
Often pain elsewhere in the body is referred to the back. For example in one of my clients an allergy to a fitted coil resulted in back pain. It took some investigation to discover what the real source of the pain was, but the pain was clearly a symptom, rather than a condition in its own right.
Frequently back pain is a symptom of muscle imbalances. Those kinds of cases can be resolved with the right intervention. Even sciatica is often not a condition, but rather a symptom. One of my patients complained about shoulder pain. She also mentioned sciatica, but have been told by a doctor that it was something she “would have to live with”.
She accepted this professional opinion as “truth”, and therefore saw no point in looking for a solution for her sciatica. Nevertheless, she was open enough to let me try to address the sciatica problem. It turned out that the sciatica was a symptom of muscle tension, and once that tension had been relieved her sciatica disappeared for good.
Armand: Okay, I understand what you mean by “symptom”. But how do you define “a condition”
Kelly: Pain associated with stenosis is an example of a condition. No amount of training or manipulation is going to make it go away, though the pain can be managed. In those types of cases it is correct to talk about “a condition”.
Armand: If the vast majority of back pain is treatable why are there so many people who don’t seem to recover from chronic back pain?
Kelly: I see two main reasons why many people don’t recover from chronic back pain. The first reason is lack of appropriate knowledge. The second is related to mind-set.
Armand: How can people lack knowledge when so much is available online?
Kelly: Yes, there is a lot of information available, but it often isn’t accurate or appropriate to the person seeking to recover from chronic back pain. For example, sometimes clients come to me and say that they have researched on the Internet what exercises to do. When they show them to me it’s obvious that those exercises are not suitable for them. That doesn’t mean the exercises are bad, they’re just not right for that particular type of back pain. Standard solutions simply don’t work. Many people don’t know that. So, I think a one-stop quality online resource, like BackMentor.Me, which advocates a personalised multifaceted approach is very valuable and will help many recover from chronic back pain.
“Tennis elbow” illustrates the general point that people often don’t know what to do about their ailments. Professional tennis players don’t get “tennis elbow”, only tennis enthusiasts do. That’s because professional athletes know how much time to spend on training, warm up, rest etc. And they know what exercises they need to do. Tennis enthusiasts don’t have that knowledge and insight.
Also, most people don’t know that a slipped disc often isn’t a life sentence. On the contrary they think they are stuck with the pain forever, because that’s what doctors tell them. If you believe there is nothing you can do to recover from chronic back pain, you will stop looking for solutions.
The fact is, however, that discs don’t “slip” because top and bottom of the discs are firmly attached to the vertebrae. Muscle imbalances and weakness put more pressure on the discs and this compression may then result in a disc bulging, but the disc doesn’t actually move or slip. Strengthening up the core muscles provides a natural traction effect on the spine, which makes the bulge go back in again.
Armand: So, why don’t doctors just tell their patients that strengthening up is the solution to their disc problems?
Kelly: I don’t know, but I suspect that it’s because in some cases this may not happen. For example, in elderly people the discs may have suffered significant wear and are structurally not the same as they used to be. So, strengthening up may not make a bulge go back in.
Armand: You mentioned “mind-set” earlier as the second reason why many people are not recovering from back pain. What do you mean by that?
Kelly: Simply put, a lot of people with treatable back pain continue to suffer because they don’t spend enough time taking care of themselves.
Also, people don’t tend to care about prevention until after they’re in pain. Very few people come to me and say “I would like to make sure I am in good condition so I don’t get problems.” The few clients, who said exactly that, were inspired by somebody they respect who already recovered from an injury or pain.
So, “mind-set” or thought patterns play a large role. I have helped a client strengthen up and recover from severe pain so she could get back to work again. She was willing to establish her own fitness routine and only came back occasionally to make sure she was on track.
By contrast, another patient did not want to undertake enough physical strengthening on her own and, therefore, needed to see me every three weeks. Though I tried to convince her to do the exercises and training herself, she preferred to return every three weeks. She thought she was too busy to do it in any other way. Her mind-set was, “if I pay Kelly every three weeks I’ll be okay to function “.
Sometimes people just don’t want to put in the time and effort to take care of themselves, even when it’s obvious that’s what’s best for them.
Armand: Is there anything you can do as a trainer to help people get motivated?
Kelly: One effective approach is to design a 15 min morning exercise programme for the client. Once the benefits start to become apparent, the client will want a little more to try out. Bit by bit they then get motivated to try more and more.
I also train people to listen to their bodies and do something about those niggles before they turn into real problems.
Recover from chronic back pain – Key points
- In most cases back pain is a symptom, rather than a condition in its own right.
- Lack of knowledge stops many people from recovering from back pain.
- Being stuck in unhelpful repetitive thought patterns also stops many people from recovering.