Living with Long-term Back Pain

“Pain is real. But so is hope.”

When we experience pain for prolonged periods, how our nervous system reacts to the pain changes. It gets more sensitive, more irritable and better at producing pain” says our head physiotherapist, Juli-Ann Riley, who has a special interest in the management of chronic pain.

“The current guidelines on the management of chronic low back pain include medications like NSAIDS and anti-depressants, physiotherapy like massage, spinal mobilisation and specific stabilisation exercises and psychological therapies. General movement and activity has even better results . A combination of the above seems to be most effective and a multi-disciplinary approach, with therapists trained in the management of chronic pain, is the Gold Standard. Interestingly enough, no type of surgery is recommended in the guidelines and surgery should only be considered after 2 years of conservative therapy. Obviously, everyone is different, and this is why a thorough assessment and individualised program is important.”

What can you do for yourself? Juli shares some tips: “Eat a fresh & healthy diet and minimize foods that increase inflammation (and can sensitise the nervous system) like sugar, white flour, processed foods, caffeine and alcohol. Get enough good quality sleep. We all know that pain affects sleep, but research now shows that poor/insufficient sleep also causes more pain (due to increasing the sensitivity of the nervous system. Relaxation (breathing techniques, guided visualisation etc) helps to ‘re-set’ the nervous system. Keep moving – avoid prolonged positions. Stay active – start low and go slow. Do joyful activities!”

Juli has published a paper on “pinched nerves” and presented this at a National Physio conference. She was chosen and trained as an IASP Pain Ambassador and has lectured pain management to various healthcare professionals throughout the province. She co-runs an inter-disciplinary pain rehabilitation clinic and assists individuals with chronic pain.

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