Persistent back pain

Persistent back pain is pain that has continued for more than three months.

What causes persistent back pain?

Typically, with persistent pain, you continue to send and receive messages of pain, even though physical healing to your body has taken place. The original injury can leave your nervous system overly sensitised after the damage has been resolved.

There may also be an ongoing issue with a structure in the spine that is a continuing source of pain.

Some people even experience persistent pain without any past injury or evidence of tissue damage.

What are the symptoms of persistent back pain?

By its nature, persistent back pain will appear to be a continuation of the symptoms you experienced during the first three months of your pain episode.

We all experience pain differently. There are many factors that affect the amount of persistent back pain you might feel.

These include coping with other sources of pain in your body, the altered movement patterns or postures you might have adopted to cope with pain, and psychological factors such as anxiety and depression, as well as memories, thoughts and beliefs.

How is persistent back pain diagnosed?

Back pain is regarded as persistent after three months. However, this does not mean that it is automatically assumed to be a chronic or long-term physical condition.

Nowadays, most medical professionals would rather take a holistic view and consider the multiple factors that might lie behind your perception and experience of persistent pain.

What are the treatment options for persistent back pain?

The key to treating persistent back pain is to learn to manage it yourself. Whether your fear or anxiety about pain is affecting the way you perceive it in general, or whether you have associated a particular activity with feeling pain, your brain is in the ‘driving seat’.

Even if the feeling of pain cannot be completely eliminated, you should be able to reduce its impact on your thoughts and therefore on your everyday life.

Remain as active as possible and try not to avoid activities because you anticipate pain. If you have not gone for a walk or played a favourite sport since the initial onset of pain, try to re-engage, but at a lower level, and work your way back from there. Pace yourself rather than push yourself and you will regain confidence in your body.

The more you achieve, the better your mood will be and the more likely it is that you will be able to break out of any negative cycle of low mood, depression, inactivity and pain.

If the pain flares up again, try to recognise what might have aggravated it, but do not let this dishearten you. Manage the pain as before with painkillers, exercise, etc. and it should settle down again quickly.

What is the prognosis (outlook) for persistent back pain?

It most cases it should be possible to see a steady improvement and to return to a normal life, free or relatively free of pain.

If you have struggled to self-manage, speak to your GP, who should be able to recommend further options, from physiotherapy to Cognitive Behavioural Therapy (CBT).

In a small minority of cases, a review of surgical options might be considered, although surgical interventions are unlikely in the absence of any tissue damage to repair.