Seven reasons your back pain is not getting better

Almost all of us would have back pain at some point in our lives. For your case, the back pain may be lasting a little longer than you’d like. It’s not bad enough for you to call emergency services, but frustrating enough for you to need help.

Before investing the dollar into professional treatment, you want to know why you are not getting better. We get that.

Today we share with you why people struggle to get long-term results in their recovery, and what you can do to help yourself find true freedom from pain.

You have been physically inactive.

You probably already know this but we are going to rehash it again: You need to exercise!

You don’t expect yourself to be healthy if you don’t eat enough nutritious food. Similarly, you know you will be tired and fatigue if you don’t get enough sleep.

So, why is chronic pain any different?

In other to be physically healthy and free of physical pain, you need exercise.

The World Health Organisation and even Ministry of Health (Singapore) are clear that you need to exercise. Beyond the usual cardio exercises, you will also need muscle strengthening exercises to keep your body robust and resilient. Not only does strength training make your muscles stronger, it also make your joints healthier.

This means better physical well-being, and less pain!

Our bodies are designed to move. In fact, as a species, we have never been more sedentary ever! Back in the days of the vast savanna, our ancestors would walk almost 10km everyday!

Technology has brought us lots of comfort and convenience that contributed to a sedentary living. As a result of this physical inactivity, we are getting sicker and chronic pain is becoming a bigger issue.

If you have been struggling to clock enough exercise in your daily routine, check out Pom Pi Pi CrossFit. Founded by our chiropractor Jesse Cai and his ex-client Tee Yee Yang, the CrossFit box is set up for beginners to learn how to exercise in a safe and meaningful way.

You have been trying hard … doing the wrong things.

We know you have tried to make yourself feel better! The bad news is that most of the things people turned to are, according to the latest research, not effective.

For example, many people love to stretch our their tight muscles and they think it will help them get better. Sure, you may feel a temporary relief. But what happens after?

Your pain always comes back.

If you dig a little deeper, it does make sense. What do you think happens to a rubber band when you stretch it?

It becomes tighter!

Sure, it does become looser if you stretch a rubber band over and over again. But, does it do its job better than a fresh rubber band?

No. They become weaker. They cannot support as much tension. They tend to snap.

We need to rethink recovery beyond the traditional “you are heaty” or “your muscles are too tight” narratives. This is the first step to ensure that you will get good chiropractic treatment outcomes.

The solution is not to make your pain feels better. The true solution is to make your adaptable body more robust and more resilient so you can go about your daily activities without your aches and soreness.

This is why our clients rave about the long-term results they get from us. We don’t focus on short-term shiokness. We work with you to come up with a recovery plan that will truly help you achieve long-term outcomes.

This means starting with exercise to get your body moving and getting your baseline fitness up. Some of you may already be physically active. For your case, we will be looking at what you are missing in your own exercise routine.

Why are your exercises not working out for your pain management? What do we need to change to help you find your own pain solution?

Once we have figured out what works, we package this information into small bits for you. We take an education and lifestyle change approach to help understand your own body, so you can self-manage in the years and decades to come.

Instead of giving you a fish, we teach you how to fish for your own recovery!

You coddle your back pain and give in to its every whimp.

I love working with parents and teachers because they know that coddling anything isn’t going to get you anywhere. The same applies to your own lower back pain.

When people experience pain, they often start to avoid the pain. You may avoid your pain because you are worried that you are going to make your condition worse. You may start to sit more, spend more time in bed, or even cut out on social activities. All of this are extremely likely to make your condition worse.

Virtually all clinical guidelines for low back pain advise for chronic pain sufferers to stay active. No, we are not asking you to go run a marathon or squat 2x your body weight in spite of your pain. We are saying there’s no need to avoid pain entirely!

This is because your body is resilient enough to support daily life activities. Even if it hurts a little. Just because it hurts doesn’t mean that your condition is worsening. If you want long-term results, you’ll need to understand this.

You see, it’s possible for humans to feel pain without injury. In fact, it’s common for people to feel pain without injury. This is because, evolutionarily speaking, pain works as a warning system. Your brain gives you a pain experience so you would be careful.

It is, however, NOT an indicator of injury.

We experience pain without injury all the time in our daily lives. Think of how much it hurts when you step on a lego brick. How about the foot reflexology stones that you can walk on in public parks? They hurt. A lot! Despite the immense pain, there is no injury.

Yes, it is true that in some rare circumstances you can worsen your injury with activities of daily living. This is extremely rare. When in doubt, seek professional help. Our evidence-based chiropractor will be able to ascertain what are suitable activities for you, and help you get to living a happy, full, and functional life.

Everything hurts.

Most of you would have more than one pain complaint. This is generally what we see in chronic, persistent pain cases. In fact, it’s so common that research has labelled this phenomenon as multisite pain.

So, recovery becomes challenging for you. I get that.

Your back hurts and you try to workout. Then your knee hurts and you have to take a break. Even when you try to push through, you may find your back hurting even more, and you are now forced to take a really, really long break.

Sounds familiar?

This is why professional help is important. This is true for almost all situations in our lives.

Have a think about it. How many of you bake your own bread? How many of you fix your own broken pipe?

Some of you? Sure.

How many of us do our own home renovation here in Singapore?

I am guessing none.

With all the home improvement tv series, and YouTube home renovation tips, ALL the information you need to zhng up your own home can be found online. Yet, we don’t do that because we acknowledge that it is not our subject matter expertise, and we seek professional help.

Your pain is no different. We get that it hurts everywhere. We get that you are trying to help yourself. It is indeed very commendable.

Perhaps it’s time to seek professional help from someone who can guide you through this challenging time?

Remember, our mission at Square One Active Recovery is to make our own services redundant to you. We are here to support you. Not scam your money.

You are genuinely afraid of injury yourself again.

We see this so often. Especially in older adults. There’s a genuine fear that exercising can damage their joints. They are worried about bending over because they think it’s bad for their spine. They are also worried about squatting because it’s think it’s bad for their knees.

As time goes, they realised they lose mobility in both their spine and their knees. Eventually, we do start to see muscle atrophy. Their lower body muscles starts to waste away, and they are physically unable to perform simple daily tasks such as walking or climb stairs without pain.

You don’t want that.

We get that pain is scary. It’s challenging to navigate. This is why, again, professional help is important.

The truth of the matter is that there is no way to we can make a blanket statement that will stand true for all of our readers, regardless of their conditions. So, we can’t really give you meaningful advice without first knowing more about your case. This is where professional help kicks in.

What we can share with you is about what other people experience prior to their recovery with us. We do this in hopes that you can avoid it for yourself, and have a much more pleasant recovery.

We do get that you are afraid of hurting yourself further. But that’s not the way to live. It’s not good for your mental well-being. It’s definitely not good for your physical health.

One of the reasons why we don’t stop at pain relief or exercise is that we want to reduce the chance of your problem coming back. In the small chance that it does, we will equip you with the knowledge and skills necessary to deal with this. In short, we empower you to help yourself.

Too often, pain patients think the absence of pain means a full recovery. This is not true. This is probably why you are getting injured over and over again.

Let us help you help yourself find true freedom from pain. We promise it will make a difference!

You are afraid everything will fall apart once you stop treatment.

One of our clients saw a chiropractor for a whopping FIFTEEN years before coming to us. We totally get why she did that because fear is very powerful. What we don’t get is how some chiropractors in Singapore are comfortable with disempowering their patients. This is not what healthcare is about!

We remembered getting her to start exercising was painful. She was experiencing symptom aggravation with exercising, and she was really worried that her body would not be able to support simple bodyweight exercises. Her fear that her body would fall apart was more crippling than the physical stress we were introducing to her body.

We took it slow and easy, and over a couple of weeks, she noticed that she is getting stronger despite the discomfort she feel. She noticed that she could do more things in her daily life. She also noticed that the aches and soreness she was experiencing started to reduce.

After working with us for 12 weeks, she was 100% symptom-free. Not only that, she was also stronger and her attitude towards exercise has changed. She lifted weights for the first time in her life working with us, and she continued to do so after her recovery with us.

This is why a whole-person recovery approach is important. This is why effective chiropractic treatment is not just about having your joints cracked. It’s about finding a true solution for your back pain problem. It’s about helping you find symptom resolution and while doing so build meaningful health habits that will reduce the chance of them coming back!

Fear is a very powerful tool. We get that you may be continuing with certain treatments because they helped you feel better in the past. We get that you don’t dare to stop because you have been told everything will come back once you stop.

This is really just fear-mongering marketing and have no place in healthcare!

You reject best evidence low back pain treatment.

For you to get better, you need to accept that there are some treatments that work better than others. You must also be willing to accept that this is unlikely to be what you think is the best treatment.

Have a think about it. You are probably reading this because you want a better pain solution. You have already tried various treatments and you are not getting results.

Why?

Because what you think works is not what actually works. That led you to choose treatments that are less effective, or perhaps totally ineffective, so you still have pain. So, you are still looking for additional help.

Let’s face it. If what you think works work, and what you have been doing works, you wouldn’t be here.

Of course we can’t force you to take our word for it. What we can do is to provide the resources and references for you to reach an informed decision. If you feel you need more support in understanding what best practice low back pain looks like, we are happy to chat more about it.

All of you are trying to help yourself get better. Honestly, we get it. And we want to help you make it easier for yourself. So, we are going to tell you upfront what works. Free of charge.

Exercise plus education. No published clinical guidelines disagree with this recommendation! Everyone in the world agrees that this is the best approach for you to get good, long-term results.

While we are on that note, you would also want to consider what doesn’t work.

Ergonomic chairs and standing tables are not effective pain treatments. No, we are not saying that you don’t feel better. They can indeed be very comfortable! What we are saying is that they are not pain solutions. While they do alleviate your symptoms, they don’t actually change anything in your body in a meaningful way for you to achieve recovery.

Chiropractic treatment for back pain

As a chiropractic clinic, we have lots of questions on why we don’t offer chiropractic adjustments. The short answer is because spinal manipulation is not a long-term solution. If it is does indeed lead to a meaningful recovery, then why are chiropractic patients expected to check in on a regular basis for the rest of their life?

For us, that’s not recovery at all. For us, recovery is about empowerment. It’s about taking charge of your own life. As chiropractors, our role and responsibility is help you facilitate that. This is why we empower our clients at Square One Active Recovery. This is why we make our own services redundant to our clients.

We use exercise, education, and lifestyle change as the core tenets in our recovery programme. With this approach, we are able to help our clients help themselves find true freedom from pain. This is aligned to best evidence practice, and also congruent to what chiropractic is about since its founding days.

In that sense, we are not reinventing the wheel.

The truth is that exercise has been part of chiropractic since its infancy. We see that early chiropractors did utilise exercise as part of their treatment approach. So, what we are doing at our practice is 100% part of chiropractic.

Yes, we do realise that few chiropractors in Singapore do what we do. It makes sense. Afterall, spinal adjustments only take five minutes to perform and the relief lasts for a few days or a couple of weeks, max. This means it’s good for business!

Then turnover is high (i.e., can see many patients in a day) and the recurring revenue is high (i.e., patients have to keep coming back). No wonder chiropractors choose to focus on cracking spines!

We are not saying that you don’t feel better from having your spine adjusted. We are saying the results don’t last. We are also saying that there are better pain solutions. Research backs this up.

With the growth of science and research, we starting to learn more about body, and what actually helps with recovery. Both chiropractors and pain patients alike would have to keep up in order to achieve good outcomes. Yes, all of us have our own biases, beliefs, values. We are not denying that.

What we are saying is that, at some point, all of these have to go if we want good outcomes. We have to keep up with times. Especially if you are not getting better.

Have a think about it. You can’t keep doing the same thing and expecting a different result. What you need for extraordinary results is a radical change. This can start with the type of treatments you choose.

Exercises you can start trying today for back pain relief

It’s very unlikely that you will achieve good outcomes from just doing the movements we are about to share. However, it is possible that one or more of them can bring you some relief for the time being.

It is important to understand that while everybody can exercise on their own, and that there are tons of exercise resource available for free online, what you need is to be able to put them together in a meaningful way to get good outcomes. This require professional expertise.

While exercise is known to help with chronic pain, it’s not reasonable to expect that you can do any random exercise to feel better. You’ll need guidance on what is the right exercise to do, when you should do it, how often, how many times, and at what intensity.

Depending on your case, we have had clients who would have exercises that are prescribed to be done hourly! Every case is different and what you need will be different from what another person needs. This is why a personalised approach to recovery is also important.

Supine Isometric Leg Press

When it comes to exercise, people expect movement. However, some of the best exercises in recovery, especially in the early stages, do not require movement. We call these exercises isometric contractions.

The word isometric can be broken down to iso- meaning same, and metric meaning meter or relating to distance or length. Thus, isometric exercises are performed with your joints being kept at the same distance (i.e., no movement). It can also be thought of as muscle length being at a fixed length (i.e., no true shortening of muscle).

For those who want to dig deeper into why isometric contractions are helpful, well, research says so. Isometric exercises have been demonstrated to induce a hypoalgesic response. That’s a fancy way of saying that you will experience less pain after doing it.

• To start, lie on the floor with your knees at a 90 degrees angle and your feet against a wall.
• Once you are in the position, allow yourself to take a few seconds to settle into it.
• You may begin the leg press by pushing both feet into the wall.
• Hold the contraction for 6 to 12 seconds before relaxing.

It’s possible to push as hard as you want but most of the time keeping to 40-60% of full exertion is enough. If you feel very comfortable with the exercise, you can gradually increase to exertion to 80%.

To take the difficulty of the exercise up a level, you can change it to a unilateral exercise. Instead of pushing both feet at the same time, push one side and hold for 6 to 12 seconds before changing to the other side.

Bear Crawl Arm Raises

This is also an isometric exercise for the low back. While there is arm movements involved the low back, if the exercise is performed accurately, remains in a fixed position throughout the exercise.

These exercises are very useful for patients whose lumbar spine are sensitive to movement. If you find that movements tend to aggravate your pain experience, switching to isometric exercises can give you a starting point into your rehabilitation. Instead of pushing through the pain, start with isometric exercises can give the lumbar musculature the activity it needs without flaring your pain up.

• To start, get into a crawl position with your knees, hips, and shoulders are 90 degrees. You should find that your wrists are directly below your shoulders and your knees are below your hips.
• In this position, slowly raised both knees a tiny bit off the ground. Be extremely careful of this as most beginners would have a tendency to raise their knees too much. Just a couple of centimeters will be good enough!
• Once you are ready and feel stable, you can slowly raise your arms one at a time. Aim for slow and controlled movements so there is minimal movement at your lumbar spine and pelvis.
• Slowly bring your knees back down after you have completed the desired repetition of arm raises.

The bear crawl arm raises can be fairly high in intensity so do be extra careful with it. You don’t want to anyhow whack the exercise only to find yourself making your condition worse.

I have tried your exercises and I am not better!

Do not be too discouraged if you find the exercises aren’t helping you. This is not because exercises are useless or that you will never get better. What you need is probably extra attention for your case, and a recovery programme that is truly tailored to you.

Remember, good results don’t just come with exercise alone. Pain relief alone also doesn’t indicate complete recovery. A combination of exercise, education, and lifestyle change is what it takes for you to find true freedom from pain.

To find out more about how we can help you help yourself in your recovery, reach out to us via the contact form below. Come discover the difference the right care can make.