How can I prevent lower back pain / sciatica? Part 1
How can I prevent lower back pain / sciatica? Part 1 of 2.. In part 2 I’ll be covering the detail of the steps that you can take, whereas this episode very much focuses on the how, the method. We have six pillar episodes in the ActiveX back show. In these I cover the foundation of understanding your lower back and sciatica. And how to recover from and prevent lower back pain and sciatica. Diving right into this episode, we’re focusing on the HOW.
In a previous episode, I introduced you to the Cliff of Pain. So now you are down in the Sea of Pain. You want me to help you get back up onto the cliff top to be out of pain again. However, if that’s all we do, then you are still on the edge. 60% of lower back pains recur within a year. You’re extremely likely to fall off that cliff again and find yourself down in the Sea of Pain again within a year. I have seen literally thousands of people over nearly 30 years of practice who have yo-yo’d in and out of the Sea of Pain despite my best intentions. I’m aiming to try and help you to prevent doing the same thing. So how do we do that?
How can I prevent lower back pain / sciatica? Set a goal
Well, to get back from the edge, you need to set a smart goal. Which is specific, measurable, achievable, relevant, and timely. You’re certain to set a relevant goal, because you’re focused on relieving and preventing lower back pain or sciatica. By specific what I mean is having a measurable outcome. So if you set a vague goal like, “I want to be pain free”, then you’re not as likely to achieve that as if you are much more specific and timely and so on.
There’s a guy Jim Collins who was a management guru. And he described what he calls a big hairy audacious goal. And we know that if you set a big goal, you are far more likely to stick at it. If we look a little bit more closely at that Cliff of Pain metaphor, again, the problem with just wanting to get out of pain is it only takes you as far as the cliff top. It doesn’t take you back from the edge. And therefore you fall off again. So I would recommend that you set a big hairy audacious goal. Get right back from the edge.
State what you really want
Focus on what you really want to achieve in the long term. That means not just avoiding pain.. It means aiming to be able to do something, presumably an activity. And that could be sitting for an hour without pain.
An example of the smart goal that gets you right back from the edge would be “I would like to be able to sit for an hour without experiencing any back pain at the time or following on from that. I’d like to do that by the 1st of January, 2020”. There’s your timely element. Now is it achievable? And for that you may need a little bit of clinical guidance. But largely speaking, the longer you’ve had a problem with an activity, the longer it takes to be able to get back to that activity without pain.
Now bear in mind, when you set that goal, it’s much more motivating, therefore you’re much more likely to stick at it beyond your initial resolution of pain. So being able to run a marathon is much more motivating than just getting out of pain. Now, my insight from nearly 30 years of practice, is that your journey back right back from the edge of the cliff will not be a straight line.
Prevent lower back pain / sciatica: the highs and lows.
There will be bumps in the road. Be prepared for little slips. So if you have a bad day or a bad week, don’t think “Oh, this is not working” and just go back to your old habits. You have to stick at it. And that takes me to the next point. This will be a journey of many small steps. No one leaps straight from the Sea of Pain to right back from the edge. It’s just not doable. Your problem has almost certainly come about as a result of many contributing factors. Go back to listen to episodes one and two to learn more about that.
Therefore the road to recovery and long term resolution and getting right back from the edge will take a while. This is not an overnight job, but let’s throw in another metaphor – it’s like “eating an elephant”.
How do you do that? You do it one bite at a time. So it’s the same thing here. This will be a series of small steps. But it helps if you know where you’re going. So set that big hairy audacious school. Be really specific; make sure it’s measurable, achievable, relevant, and timely. Put a time and date on it, and you’re far more likely to stick at it.
Example of good practice
I was listening to a podcast the other day and in it there was a physio, an Australian physio. And they have this program called The Finish Line. I thought it was fabulous. I love the concept because they put a finish line on all of their clinical goals. So they say, “Okay, so you want to achieve this by the 1st of January or by the 31st of December, whatever date that may be.” And that creates a finish line for their program of care.
And as the physio (who I think is a competitive triathlete), said – when you see a finish line, you just put everything into getting to it. Consequently, having a time that you’re aiming to achieve this by makes it more likely that you’re going to throw a lot more of your resources into this. I really, really recommend saying “by such and such a date I will have achieved” whatever it may be.
There will be a bunch of small steps. But we as clinicians can help you much more when we know what the goal is that you’re aiming for. Once we know the goal, we can plan the steps to get there. Yes, there’ll be a whole bunch of small steps, but that helps to keep you motivated. So we know that if we can see the big goal, then we plan the smaller steps to get there. And every time you hit one of those small steps is a cause for celebration. So big goal, small steps.