Wow! The holidays are upon us this month…….
HOLD UP! The holidays are WAY beyond us. I am a true example of how life can get past us. But here I am back and ready to post! Happy New Year everyone!
I seem to notice an increased number of my patients coming in with elevated pain. Pain from cooking and preparing that Thanksgiving meal, pain from putting up Christmas lights all day, pain from getting in and out of the attic for decorations. But not even just the holiday festivities, winter is upon us and we are going to have to start shoveling snow, chipping away ice off our windshields, taking the trash out on icy driveways…PLENTY of activities to aggravate our already present back pain.
Sometimes just the thought of doing any of these activities could be scary. You just KNOW this is going to flare up your back pain!
What if I told you the threat of the idea of the pain could actually cause your pain?
I had the pleasure of seeing Adriaan Louw discuss his very important concepts on how the brain processes pain and how our body perceives it. He is the founder of International Spine and Pain Institute and has plenty of products for sale here Maybe some people have heard of Neuroscience Education? Well, he is the godfather!
He graciously allowed me to discuss his teachings and also share one of the exercises he came up with to help with chronic pain. I am so excited, I can’t stand it!
Firstly, I have to say that we are still in the archaic ages with our full understanding on how pain is perceived. Dr. Louw and his team are working hard and coming up with more and more research supporting his concepts. But what I love about it is it is sooooo simple. Anyone can do it!
To put it simply, when we suffer pain for a period of (about) 3 months or longer, it can make changes in how our brain hemispheres communicate with each other. Dr. Kutch has found that people that have suffered painful bladder syndrome have increased communication between their left and right sides of their brain. Whereas, asymptomatic people that were introduced a painful stimulus showed only strong communication along the left side of their brain. The brain can make changes and pain can make each side talk more to each other.
These open pathways in the brain cause almost an overload to your body. There is too much firing and not enough quiet. Our brain organizes how it communicates to our specific body regions like a half rainbow. You may have heard of the homunculus? Probably not, but let me explain.
Imagine your head with your brain sitting inside, it would look like a rainbow shape from ear to ear. One half of the rainbow is the left side the other, the right side. It would seem sensible that the top part of the rainbow should be the head, then the neck, then torso, then the arms, and on and on………
But it doesn’t organize like that! Remember my post about pelvic pain and foot pain? Guess what? The genital organ section is beside the foot section in the brain! The brain does not organize our body parts in what we would think a sensible order.
So, if you are having prolonged pain there is abnormal firing occurring in the brain. And this can have a crossover effect. Adrian Louw terms it “smudging.”
Acute pain is usually localized. Chronic pain is all over the place. It is hard to say exactly where it hurts. This is because the BRAIN is smudging how it is processing the feedback it is receiving. Shoot, there isn’t even a reason why you’re having the pain. Sure, you have a confirmed bulging disc on your MRI. But guess what, so does 70 people out of a room of 100 people that have never had back pain.
Here is a simple exercise for your brain. You will need a partner to help you. You will also need a tape measure and pen. A tape measure is not mandatory, though, you could eyeball it if needed. I only say that because I can NEVER find my tape measure at my house.
Localization Exercise:
I am going to use the example of low back pain.
- Lay on your stomach on your bed. Let’s say your right lower lumbar spine/back always hurts. Have your partner take a pen top and gently press along your painful region. Find the most painful spot. This could be done on your buttocks region as well… anywhere there is pain really. Ok, the most painful spot will be assigned #5. You will be making a large box around #5, assigning 9 total numbers to the square.
- From #5, measure 5 cm directly above and below making a straight line with three points. The dot above #5 will be #2 and below, will be #8.
- From each dot, measure 5 cm to the right and left. From #2, you will assign #1 and #3. From #5, assign #4 and #6. From #8, assign #7 and #9.
- You should have a 9 point square drawn on your back. You will not need to fill in the lines.
- Your partner will press the pen top into each point explaining to you what number that point is assigned. You will press about 3 mm into the tissue so it will be enough to give a moderate pressure. If too painful, start lighter. Your partner will hold the pressure of the pen for about 2 seconds. It should not be quick or less than a second.
- Your partner will continue to go through the points on the square quizzing you what number it is. If there is a certain area where you cannot tell the difference between 4,5,6,9 then continue to work in that region.
- There are no limits on the amount of time you practice this, but I recommend doing about 5 minutes at first and doing this 2x/daily the first week or so. If you start getting better at it, then reduce the time and practice one time a day.
You will be amazed! In my clinic, I have noticed a 20-30% drop in pain after doing this simple exercise immediately without doing any other treatment! Adriaan Louw has also published an article with similar findings.1
This can also be done on the shoulder, knee, and foot. Just make sure you adjust your square size to the particular body part. And patient, do not watch! Keep your eyes off that body part!
Practice every day for about 3 minutes. If you are having a hard time differentiating the points in the square, then start with doing it twice a day.
If I have anyone try this exercise, please reach out to me and let me know how it is going! I would love feedback.
- Louw A, Diener I, Puentedura EJ. The short term effects of preoperative neuroscience education for lumbar radiculopathy: A case series. International Journal of Spine Surgery. 2015;9:11. doi:10.14444/2011.
This new year has surged a large amount of energy from me. Lots of ideas bursting at the seams! Having two young children and working a fulltime job can be so exhausting, yet so fulfilling. I am trying to make it to my weekly tap class which is really hard at 8 PM on a Wednesday. But worth it! Please remember no matter how busy you are, take time for yourself! I look forward to sharing my exciting plans with you this year!
Watch my amazing video that teaches you how to self correct your pelvic alignment to help with back pain. Next post will be explaining this very topic!