What if I were to tell you that this was not entirely true?
What if I were to tell you that the words a clinician uses with their patient can have a profound impact (good and bad) on how a patient experiences their pain?
Well surprisingly or not language can have a significant impact. But first let us back it up for a moment and define pain. According to the International Association for the Study of Pain, pain is defined as:
An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage (Merskey et al, 1994).
Now with this in mind, information that can lead to pain (nociception) can be generally speaking, managed/modified at the site of injury, spinal cord or in the brain.
Now this is where particular a clinician’s language and a patients thoughts and beliefs about their back pain can make a big impact. But instead of me going on about impact of thoughts and beliefs I’ll leave that to pain scientist Lorimer Mosely at this TedX talk
Back to language and back pain. What we do know is fear avoidance beliefs impact on the prognosis of back pain and negative language forms a part of this (Wertli et al, 2014). We also know that advice, simple exercise and reassurance are also generally recommended with most of the current guidelines for the management of back pain. So the key is then to ensure us, as the clinician use positive language and reinforce positive beliefs in line with the best evidence that’s out there to lessen the impact of pain. A good example of this would be using the phrase:
“Your back will get stronger with movement”
“Your back is weak.”
A great summary of the messages that are helpful and unhelpful for those with back pain is available here.
To help me summarise, firstly watch this video by Professor O’Sullivan here as it provides a much succinct explantion using patient’s first hand experiences.
Finally, yes language plays a significant role when it comes to the management of back pain and a change in your clinical language and patient’s thoughts could make all the difference.
Because your health matters.
- Merskey, H., Bogduk, N. (1994) Part III: Pain Terms, A Current List with Definitions and Notes on Usage” (pp 209-214) Classification of Chronic Pain, Second Edition, IASP Task Force on Taxonomy. IASP Press, Seattle
- Wertli, M. M., Rasmussen-Barr, E., Weiser, S., Bachmann, L. M., & Brunner, F. (2014). The role of fear avoidance beliefs as a prognostic factor for outcome in patients with nonspecific low back pain: a systematic review. The Spine Journal, 14(5), 816-836.
- O’Sullivan P and Lin I 2014, ‘Acute low back pain Beyond drug therapies’, Pain Management Today, vol.1, no. 1, pp. 8-13.