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A neurological healing process (for back pain)

 •  • by Paul Ingraham
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Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

This article is an unusually awesome short introduction to modern back pain science: “Babying your back may delay healing: Exercise and movement may be the best medicine for back pain.

There’s not a sour note in it: nothing that I think is a myth, no annoying oversights, no obnoxious oversimplifications. And yet it’s relatively concise and clear! I wish it had a byline — I’d love to give the author credit for the clarity — but the ideas are all coming from Dr. James Rainville. It’s not structured like an interview, but his expertise is the point of the piece. I especially loved this bit of thinking:

The oddities of back pain are likely due to the fact that a neurological healing process — not a physical one — is at work, says Dr. Rainville. As the theory goes, when a problem occurs and triggers pain, it’s your nervous system that actually adapts to the pain, and that’s what makes discomfort go away, says Dr. Rainville. Exercise and movement may help your nervous system to make this adjustment more rapidly.

That goes an important step beyond anything I have clearly written down. Most of what I have written about back pain is certainly consistent with that idea … but I have also never boiled it down to that nugget. And it’s a really good way to frame it: a neurological healing process, not a physical one. That is the most concise and accurate way of explaining the weirdness of back pain that I’ve ever come across.

The article is probably not perfect, because nothing is, and perhaps some of my readers will enjoy picking a nit or two. But it is unusually good, and I am extremely hard to please on this subject: I can’t even remember the last time I read an article about back pain that didn’t get me grinding me teeth about something.

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