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How do expectations affect back pain recovery?

Gerald M. Silverman
Chiropractic Medicine
Some people tend to deal with back pain by catastrophizing or overreacting to pain. They often perceive their initial pain as serious enough to be "backbreaking." With their perception of the situation being somewhat catastrophic, it becomes entirely reasonable, almost logical, to project an equally dire long-term expectation to match that perception. With their beliefs firmly established on these perceptions and expectations, two additional reasonable reactions occur. First, it is easy to become unnerved by the severity of such pain to the point of developing an unrealistic fear of further pain or injury. And second, this fear can lead a person to avoid the very movements necessary to encourage proper healing. A large percentage of chronic neck and back pain sufferers finally come to display what is now called the fear-avoidance response.

In the very early stages of significant pain, fear and avoidance to back pain are wise and reasonable reactions. But staying in such a protective mode too long begins a series of events that will inevitably lead to chronic pain. Instead of returning to normal daily activities as soon as possible, fear-avoidant people become sedentary and guarded. Joints become restricted, muscle rigidity leads to spasms and adhesions, and a physiological cycle that produces chronic pain becomes activated. All of this gives additional credence to the patient's dire expectations and fear of chronicity. The transition from acute to chronic pain was not the result of a psychological flaw, nor was the initial pain in the person's head. Yet perceptions and values forecast the outcome and dictated how the person responded to, treated, and coped with the condition.
Your Miraculous Back: A Step-By-Step Guide to Relieving Neck & Back Pain

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Your Miraculous Back: A Step-By-Step Guide to Relieving Neck & Back Pain

Many of us complain about our 'bad back,' but this book argues that our backs are, without exception, amazing examples of bioengineering, capable of dramatic feats of strength, flexibility, and...

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.