Chronic back pain, as discussed earlier, is pain persisting for three months or more
characterized by:
Persistent pain that exceeds the normal duration of healing or resolution of injury
Difficulty in coping with the pain
Associated psychological and social problems.Social factors, such as the degree of job satisfaction, appear to be the most important
factor in determining disability associated with back pain. Financial concerns, family
support, litigation, educational level and insurance also influence outcome from a back
injury. Since these have a great influence on the outcome of treatment, the medical
history taken by the orthopod should include assessment of psychosocial risk factors,
which predict risk for chronic disabling back pain.
Whether or not there are yellow flags, further management remains the same. There is
no doubt that if one or more of these yellow flags are present, it becomes easier to
counsel and treat the pain.
If your back pain has not settled despite following Step Two measures for four weeks,
just stand back and think about it. Is your back pain really that incapacitating or is there
an underlying psychological or social factor that is making it appear worse than it
actually is? Is there a financial, job or litigation problem? Do you have a supportive
family or are you alone in your suffering? Or is it simply that you are scared to move and
are waiting for a miracle cure to be brought to you? A frank self-assessment is therefore
essential at this stage to look for extraneous factors contributing to the persistence of
back pain.
Treatment
Chronic pain is managed by active rehabilitation.