“You have a spine of an 80 year old, no wonder your back hurts!” Or maybe you’ve heard, “Your discs in your lumbar spine are crushed. That is probably the cause of your low back pain.” I can’t tell you how many times I have heard a patient come into my office telling me this is what their Physician told them and they are emotionally crushed by these harmful words. Physical Therapists (PTs) can be just as harmful without even knowing it. PTs have been using harmful words to try and motivate and educate and their patients for years and not understanding the devastating effects that some words can have on the healing of a patient dealing with chronic pain. A simple comment like, “Looking at your x-rays it shows that you’re bone on bone.” Or no wonder you have back pain, your core is weak.” Even comments from a personal trainer or teacher in a health club fitness class to a client that has some intermittent back pain can cause further disability if taken the wrong way. For example, “if you work harder on your core your back pain will go away.” This is very harmful and damaging verbiage. I think we all can agree that this is a terrible way for a Doctor, PT or even a fitness professional to communicate with their patients / clients.
All healthcare professionals and experts in the fitness and wellness fields are at fault and we all need to start changing the message we give to our patients and clients. These are harmful words and need to be stopped. Unfortunately it happens way to often all over the world and there is evidence that these types of words that “Harm” are actually creating more pain and disability in people of all ages. Negative language creates fear and catastrophizing, undue focus on structure, belief that pain = harm, and activity is harmful. Clinical studies on management of chronic low back pain sufferers in Australia have shown that these harmful words spoken to patients about their posture, core strength, lifting habits and even everyday movements have created all kinds of problems and dysfunctions in their lives. In the medical literature there is a very poor relationship between structure (e.g. joint, disc, ligament), pain and disability. So we need to stop focusing on the “structure” and focus on movement. Guess what folks, there is no consistent medical evidence that shows normal age related changes in our body causes pain. Therefore, we all need to stop using these words that “harm” and replace them with words that “heal”. We need to promote hope and confidence. Most importantly we need to help people in pain that when exercising or moving around in our day, pain ¹ harm.
So lets change our language because there is a plethora of evidence that using positive, affirming, motivational words can lead to healing. How bout, “Hey, you have some normal age related changes to your spine and if we get you moving better with less fear and anxiety your going to do fine” or “Your back injury has healed by now and its time to start moving again. You’re going to be fine” or even
“ Your back injury is like an ankle sprain. They all get better after a short period of rest”
and lastly, “Our spines are very robust and can be trusted to do a lot of work and play. Do not be afraid to bend, lift, carry or play hard. Enjoy yourself, get outside and just do it!