Immobility Can Make Your Pain Worse

21st October 2019
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The idea of a relationship between fear and pain is not new.

One of the First philosophers who linked pain with fear was Aristotle, who wrote, “Let fear, then, be a kind of pain or disturbance resulting from the imagination of impending danger, either destructive or painful”.

Avoidance behaviour, presumably fuelled by fear, has been intensively studied since the 1960s. Avoidance learning occurs when we start avoiding a certain movement because we know it may trigger the pain or simply aggravating, as a result, we unconsciously live in a state of “alert” and protection towards any action which involves that movement. We basically starting to predict events in our own internal and external environment. By doing so, we elicit a negative automatic response in which a neural stimulus receives a negative association/meaning in the brain. Avoiding the threatening situation, as illustrated is often reinforced by reductions, e.g. fear, tension and anxiety.

One of the most common health problems from which people develop fear – avoidance behaviours is when they experience low back pain. Why? Due to history, culture, myths and previous experiences we perceive our back as the weakest part of our body and as a result we feel the NEED to protect it by NOT MOVING IT or guarding it as much as possible.

Now with this in mind, try to ask yourself it you have had a “protective” thought or fear-avoidance behaviour when you accidentally sprained your ankle. Most of you reading now, would say NO, and it is not because it was not hurting enough but simply because WE DO NOT think about our ankle as VULNERABLE.

What can we do about it? Well, we need to start think differently about our backs. THEY ARE STRONG and they are meant anatomically and physiologically to BENT. If you happen to have back pain, try to frame it as an ankle pain that needs to be assessed and treated as you would do with any other injury.


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