Active Rehabilitation
Reasoning behind active rehabilitation
The initial back pain may cause a fear psychosis wherein you are terrified to make any
movement that might precipitate a fresh attack or worsen the existing pain. This is
known as “Fear Avoidance” behaviour. This “Fear Avoidance” behaviour is further
fuelled by job dissatisfaction or loss, depression or other psychosocial factors. Lack of
activity results in disuse and wastage of spinal muscles (Remember erector spinae and
multifidus muscles – it seems so long ago that we read about these muscles!!). In
addition, the abdominal and gluteal muscles are also affected leading to poor posture
control and inefficient muscular stabilization of the spine and the body as a whole.
Prolonged disuse leads to a deconditioning syndrome where the muscles are so weak
that even sitting or standing upright becomes impossible. Any slight movement can thus
produce more pain which perpetuates the vicious cycle.
PAIN
Fear of pain and Impairment in spine
avoidance of movement coordination
DISUSE DECONDITIONING
Wastage of spinal muscles
The deconditioning cycle of chronic back pain