Talkback

Back pain education from Sheffield PhysioWorks

Workbook

This workbook is yours to keep, please use it to make notes in throughout this talk. You can also take it to your physiotherapy

appointment to help with shared decision making.

This booklet was developed by staff and patients at Sheffield Teaching Hospitals and Lab4Living, Sheffield Hallam University.

How does the back work?

How will physiotherapy help?

Is my back pain serious?

How can back pain affect you?

What can help back pain?

How does pain work?

Talkback covers six areas to support recovery

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1. How does the back work?

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What do you think a spine looks like? Draw a spine here

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1. How does the back work?

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The back is a strong and resilient structure made up of bones, joints, discs, fascia, nerves and muscles.

These structures all work together to let you bend, twist, lift and move.

Changes in these structures occur as we go through life but these changes are not always associated with pain and they are all capable of some recovery and regeneration.

These changes are often visible on x-rays or scans but this does not tell us much about your pain as they are just as likely to be seen with someone who does not have back pain.

A capable back is able to bend far enough and quickly enough with sufficient control and strength to carry out the tasks required of it.

Regular activity and a healthy lifestyle need to be part of your back pain recovery plan as they are the stimulus for repair and regeneration and help keep you doing the things you want to.

Use this space to make notes

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2. How does pain work?

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The pain system is made up of several components that work together to help us watch out for possible danger and take action.

Specialist nerve endings constantly send information up the spinal cord to the pain centre in the brain.

The pain centre looks at this information looking for signs of possible danger.

Past experience, current situation and possible consequences all help to decide how much danger, how much pain and how the body should react.

The pain system takes action by tightening muscles, increasing awareness and focusing our attention with the unpleasant and persistent sensation of pain.

The pain system is able to learn and adapt but does not always get things right and sometimes overreacts, this is why sometimes pain can occur or increase even in the absence of danger.

Use this space to make notes

Reducing over sensitivity of the pain centre chould be included in your back pain recovery plan

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Your physio will listen to you to try and understand the problem from your perspective.

They will ask questions and examine you to make sure your back pain is not a symptom of something more serious.

They will look at how you move and work with you to devise a plan to get you back doing the activities that are important in your life.

They will discuss things you could try to decrease the intensity of your pain.

They will direct you to other sources of information and help that are relevant to your back problem.

They will help you stay positive and provide reassurance and support during the difficult process of recovery.

3. How will physiotherapy help?

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Use this space to make notes

Your physiotherapist will help make sure your back pain recovery plan works for you

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out of 100 people will have an episode of bad back pain in their lifetime.Less than in 100 cases of back pain are due to a serious medical condition.

Your GP and physiotherapist will question and examine you to see if you are at risk of having a serious underlying medical condition.

Risk factors include a history of cancer or other serious illnesses, unexplained weight loss, problems with your bowel or bladder or if your first episode of back pain occurs after the age of 65 or under the age of 20.

Investigations such as x-rays and scans can be helpful for diagnosing serious conditions but are not helpful for determining other causes of back pain.

4. Is my back painserious?

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Serious causes of back pain are rare but if you are worried that your back pain is related to a serious medical condition then

you should discuss this with your physiotherapist or GP.

Use this space to make notes

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5. How can back painaffect you?

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Important things in my life that my back pain is having an impact on.

How does that make me feel?

What changes could I make to reduce the impact?

5. How can back painaffect you?

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Pain is an unpleasant feeling that affects us emotionally and limits our movement.

When we get pain, the body responds by tightening muscles, increasing the sensitivity of the pain system, changing the way we move and making it difficult to focus on anything else.

Although helpful in the short term, if these responses continue they can get in the way of recovery.

Back pain makes it difficult to do the things that are important to us including work, sport, hobbies and socialising. We might even begin avoiding these things for fear of causing pain or doing more damage.

It can affect our relationships with partners, families, friends and work colleagues. Sleep is often disturbed.

The effects of pain can lead to stress, low mood and anxiety.

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Use this space to make notes

Recognising how pain is affecting us and communicating this to others is important. Understanding how the effects of pain are

contributing to the problem can help your back pain recovery plan.

6. What can help back pain?

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Promote repair and

regeneration

Reduce pain centre

sensitivity

Improve how you

move

Should I try this?

Does this...

Exercise

Healthy living

Pain killers

Surgery

Injections

Alternativetherapies

Relaxation

Understandingback pain

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6. What can help back pain?

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Pain killers can help to reduce pain and make it easier to do other activities that help recovery.

Movement and exercise can help to ease back pain, but it can take time to work out which is best for you.

Discussing and understanding the complex nature of your back pain can help you deal with unhelpful thoughts and emotions.

Finding ways to move your focus away from pain such as restarting normal enjoyable activities or relaxing using mindfulness can help.

Eating a healthy diet, losing weight, stopping smoking and taking part in regular moderate exercise have all been shown to help back pain.

Some people find other options help them - acupuncture, massage, chiropractor, steam baths etc. These can help ease pain to help you become more active. However there is currently not enough research to support their use in the NHS.

Your back pain is likely to improve but It may take you some time to work out what is the best back pain recovery plan for you.

Use this space to make notes

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My back pain recovery planInformation I found really useful and would like to remember

Options discussed in Talkback that I would like to know more about

Ideas discussed in Talkback that I would like to try out myself

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Things that might get in the way of my recovery plan that I need to watch out for

Questions I want to ask a health professional

Things I want to talk about with friends, family and work colleagues

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TalkbackBack Pain education from Sheffield PhysioWorks

© Sheffield Teaching Hospitals NHs Foundation Trust

PD10195-PIL4363v2 Date of issue: May 2022. Review Date: May 2025