Chronic Lower Back Pain: The Best Remedy Might Be Simpler Than You Think

Lower back pain starts in many different ways. However, about one person out of five goes on to develop chronic pain, which comes and goes for months or even years. Can somatic practices help in these cases?

The way lower back pain turns into chronic pain has to do with how the body works. You see, the body is truly outstanding, and it is always trying to soften any painful sensations by adapting to whatever is going on in your life. In the case of lower back pain, the distress might have begun because of a fall, some wrong postures you kept while lifting weights, or even prolonged sitting in the office. No matter the exact cause, the result is usually the same: the muscles of the back tighten in an effort to prevent further movements that might increase your chances of hurting yourself.

Weeks or months later, those same muscles that were trying to help become the very reason why your lower back hurts. The longer they stay tightened, the harder it is for them to let go and go back to a neutral, relaxed state. They get stiffer and stiffer, and your lower back pain increases.

When does chronic pain get worse?

If we had to point out some of the biggest players making chronic pain worse and resilient, we should look at stress and how the brain responds to it.

Stress can come in many forms. Injuries, traumas, work, anxiety, childhood issues, sadness, grief, and social isolation can all be sources of large amounts of stress. You know the feeling: your body tenses up, your mind is racing, and it’s like you cannot focus on anything. You’re irritable and might eat much more or much less than usual. You might feel the urgent need to go out to smoke or have a piece of chocolate. You might withdraw or seek someone to vent with. You might feel like moving a lot, or might not want to go out of your home at all. 

Meanwhile, your brain is changing the way your body works. Blood flows from your frontal lobe to the limbic system, which includes the amygdala and the autonomic nervous system. Any feelings of pain might worsen as a result because alertness is increasing and going at an all-time high. You might feel numb, your heart rate might speed up, or you might have headaches. If right now you’re saying, “Well, I have all of this quite often.” Then, it’s vital to fix this up.

In normal circumstances, when stressors disappear, the body returns to balance. However, for many people, this does not often happen, and the nervous system becomes stuck in a state of tension. 

Prolonged stress then turns into chronic pain. And the loop repeats itself over and over again. As you’re now more alert, you’re highly aware of any discomforts or painful sensations in the body. This reinforces the stress and adds to the fears and worries. Your pain feels stronger, and you are more likely to overthink it.

Mind-body connection for chronic pain

Some studies have looked into the relationship between chronic back or neck pain and the source of the feeling of pain. Interestingly, not all pain is equal. They took participants suffering from a wide array of both lower back pain and neck pain and tested all with imaging and other tools. Overall, results showed over 88% of participants were not feeling pain because of the injury or physical distress itself, but rather because of enhanced sensitivity and stress.

In other words, although all patients had some physical issues that needed to be fixed, their pain was not directly linked to those issues but was mainly caused by the stress-fed pain loop in their minds. This is also called a neuroplastic pain circuit. Now, would their sensations have changed if they had been taught how to calm their nervous systems?

If you’re not familiar with the term proprioception, it is used to refer to feedback loops in the brain informing us about the position of our body in space. Coordination, complex movements, and balance all rely on our proprioceptive ability, which is also called kinesthetic sense. If you lack proprioception, you are more prone to falling and injuring yourself. Feldenkrais classes are one great way to improve proprioception.

Living with prolonged pain impairs proprioception as well. Your focus shifts to the pain area, and the more you stress about it, the more it seems to worsen. You often find yourself wondering, “Does it hurt now? It was hurting earlier…” Or “How weird, it doesn’t hurt today! It will probably hurt in a few hours…” If you do, you are likely reinforcing a loop in your brain that is all about the pain, but you are also easily disregarding any other pleasant sensations. With time, this can further impair a balanced feeling of proprioception. And guess what? When your mind is all focused on pain, other negative emotions can easily follow, such as fear, worry, hopelessness, and even isolation or depression.

How to heal from chronic pain loops

“If the pain is all about stress, then is it not real at all? Is then all the pain just in my mind?” Although some part of this is true, we should not mix apples and oranges. Addressing the mind-body connection means acknowledging that both have a role in generating pain and healing. 

Of course, along with physical therapies, it is helpful to keep in mind that the brain needs some help to heal, too. As many forms of chronic pain arise from emotional and psychological stress, repressed emotions, traumas and established neural patterns, therapies like PRT can help enormously in these circumstances. 

Pain Reprocessing Therapy works by helping the patient recognise the real source of their pain and has shown great success in treating neuroplastic chronic pain. If you’ve fallen and then started having pain, which turned into chronic pain, you might go to a doctor and be told that you’re physically healthy. Yet, if you’re still experiencing pain, chances are it’s of neuroplastic origin, and PRT can help you change your neural patterns by communicating with your brain and body.

Often, clients see progress from the very first sessions. As they learn how to reframe their experience, their neural patterns change, and the stress response linked to the traumatic event weakens. With time, you learn to handle the way your brain and body communicate and might even consciously realise that a bit of pain comes back only in stressful situations. The goal is not only to become aware of all factors influencing your physical sensations but also to empower yourself to deal with them whenever they come back.

The risks of surgery and medications for lower back pain

Whenever I meet clients who are considering surgery for their lower back pain, I invite them to try more somatic practices before proceeding. While surgery is irreversible, there are no side effects to trying some new experiences, even if you’re a bit sceptical. Plus, recent studies show that patients did about the same whether or not they had surgery.

In many cases, spine surgeries should simply not be done. Studies show that the failure rate of such surgeries is between 19% and 36%, and 46% of patients who underwent lumbar fusion experienced the same pain level or worse after the surgery.

The issue often lies in what comes before the procedure. Performing surgery without carefully examining all possible causes of back pain often leads to nowhere. You might go through it and realise you are left with the same old pain.

When it comes to medication, they are like a buffer to the pain. Suppressing it can only be temporary. But if the mind is sending pain signals, you should always give it a chance to tell you something is going on and that you should pay attention.

One of my clients once came to me after falling down the stairs, and for a while, she was perfectly fine. She did all the checkups, and medically speaking, there was nothing wrong with her. Yet, six months later, she started to develop back pain that, by the time she came to see me, had lasted for over 10 years.

It was clear that the pain was of neuroplastic origin. It was not there all the time; it intensified in the moments of stress, changed the place again and again, and so on. We worked for a few months together, lowering the fear of the pain itself, letting bottled-up emotions come out, and employing the Feldenkrais method to bring the inherent feeling of safety back slowly. As she learned more about the nature of pain and its origin and allowed her body to find new pain-free movement patterns, her pain decreased a lot. Whenever she felt like it was surfacing again, she simply slowed down and was able to have a chat with her body, seeing how stress was affecting her reaction. After having tried multiple therapies, she finally found the relief she had been seeking.

What can you do to fix lower back pain?

We’ve discussed the importance of acknowledging the mind-body connection, the power of suppressed emotions, and the role of stress and the nervous system in experiencing pain. If you’ve dealt with it for a long time, you might feel like healing seems like a distant reality right now. However, it can be simpler than you think if only you are willing to give your body and mind a chance to work together. 

At MindfulBody, our goal is to help you unlearn your pain, reconnect with your body, and discover–or rediscover – the freedom of pain-free movement in Luxembourg. We do this by combining mind-body re-education, somatic bodywork (the Feldenkrais Method), and a range of pain therapy techniques (including PRT and EAET).

Lower back pain, neck pain, shoulder pain, and any other form of chronic pain result from a long series of factors that have accumulated and locked you up in a vicious cycle of neural feedback loops. By starting to understand how your mind works, releasing the accumulated stress and lowering current stress levels, learning how to use your breath, and finding new, safe ways to move your body, you can witness incredible shifts in your physical symptoms. 

If you wish to have a chat, discuss any specific health concerns with me, or delve into the ways in which I could support you on your healing journey, feel free to drop me a message at iryna@mindfulbody.lu.