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Timely help prevents constant pain

Unfortunately, many patients with chronic backache hesitate before starting suitable behavioural therapy. But such therapy can change existing habits and attitudes that have caused muscle tension. "Early psychotherapy offers good chances for preventing any further chronic development process", says psychologist Fredi Lang (Bundesverband Deutscher Psychologinnen und Psychologen - German Association of Psychologists - Berlin). "It is also worth remembering that in principle, any pain can become chronic. Just one reason why early measures are necessary", Lang adds. Taking the psychological approach is often an important step towards alleviating existing permanent backache.

Another aim consists in reducing the psychic and social consequences of chronic backache. "Our endeavour is to make life more bearable for those affected, restoring their frequently drastically reduced sphere of activity", says Lang. Interdisciplinary pain therapy therefore also increasingly focuses on psychological support.

Psychotherapy supports pain treatment

Fredi Lang
Fredi Lang

Psychotherapy intervenes in the process of coping with pain, which takes place on different levels. Classic psychotherapy consists above all in talking the patient through the various issues, while today it is common practice to include appropriate supplementary strategies. Psychotherapy can take the following approaches, among others:

  • Behavioural therapy, using self-control to improve how the patient copes with the pain, also learning pain management techniques.
  • Psychoanalysis with an attempt to track down the emotional contacts with (shared) responsibility for the pain, which can go right back to childhood. The aim is for the patient to say farewell to old behaviour and experience patterns and follow new paths.
  • Body-oriented psychotherapy, aiming to stimulate the body's self-healing forces by become intensively aware of the body functions. This is frequently successful in combination with certain relaxation techniques.

It's the attitude that counts

Anne Flothow
Hon.-Prof. Dr.
Anne Flothow

Cognitive behaviour therapy is today one of the most important psychological approaches to dealing with backache. It presumes that a person's opinions, attitudes, wishes, ideas or intentions have a major influence on that person's behaviour. This leads to a personal perception of one's own backache. As a result, the pain can be either augmented or also weakened in the person's perception. "Someone who sees backache as a real calamity will feel the pain more intensively than those who take an active approach to dealing with their backache", explains Honorary Professor Dr. Anne Flothow (psychologist in Hamburg – Board Member at the Bundesverband deutscher Rückenschule (BdR) e.V. – Federal Association of German Back Schools).

Be active, take a positive approach

Behaviour therapy therefore aims to teach backache patients how to view and reassess the pain from another angle. In sessions with the therapist, patients discover negative attitudes and can change them in favour of a new, more positive approach. "The aim is to come to the conclusion that backache does not render you helpless", explains Dr. Flothow. She advises patients to use management strategies to overcome fears, become active and boost their self-confidence.

Successful psychotherapy treatment of pain therefore depends on active involvement on the part of the patient. Only patients who are willing to play an active role in the treatment process will see long-term alleviation of chronic backache.

More exercise alleviates and helps to prevent backache

Ulrich Kuhnt

Exercise is good for you and helps to prevent backache. But most people in Germany have not yet come round to this way of thinking. Two in three Germans prefer to spend their leisure time at home on the couch, according to the results of a survey by F.A.Z. Institute and Forsa which asked 1,000 people aged over 14 years about their exercise habits. In spite of having a guilty conscience, the Germans simple can't be bothered to make the effort.

"Somehow we've just got to introduce more exercise into everyday lives. Otherwise backache will be a foregone conclusion in the long term for these couch potatoes", says Ulrich Kuhnt, sports instructor and head of Hannover Back School. We're not talking about peak sporting achievements here. Even little tricks can bring more activity into everyday routines. Do more errands on foot, take the stairs instead of the lift or get that bike out of the cellar. Walking briskly twice a day for fifteen minutes to the station or to the shop is already sufficient for inveterate lazy bones to achieve half their daily physical exercise target. A little bit more won't hurt either.

Exercise, always and everywhere

You can even exercise when standing in the queue at the supermarket checkout or at the bus stop. For example, stand really tall as if you're a puppet being pulled up on a string: this stretches your spinal column. Or stretch your muscles by bending over to the side or let the upper part of your body sway gentle from left to right.

Exercise can be integrated in everyday office routines to help counteract backache. In addition to an ergonomic workplace, physiotherapy exercises can help to prevent ailments from developing. Consult a therapist, e.g. a back school instructor or attend one of the office exercise programmes offered by the health insurance funds. In most cases you can do the little training exercises in between times while sitting or standing at your desk – without needing additional apparatus.

Changing your posture relieves your spine

Alternating movements also help to prevent one of the most frequent causes of backache, which is muscle tension. Change your sitting position as often as possible. Possibilities including bending forwards slightly, holding an upright posture or then again leaning back in a relaxed position. This is much easier if your office chair or couch at home fulfils the ergonomic requirements.

You can also introduce more exercise and variety into everyday routines by standing for a while to interrupt your sedentary activities. Brief meetings for example can also be held at a high desk. And instead of sending an e-mail to your colleague at the other end of the corridor, surely talking a short walk is a viable alternative. If you have to stand for a longer period of time, relieve your spinal column by shifting your weight from one leg to the other: changing your posture is also important when standing.