Pain and Irritability – They are not the same…..

Pain is very subjective – the most common pain scale is 0-10 – O being no pain and 10 being the worst pain imaginable. Where do you rate yours?

People have walked into our clinic and look great and move OK and give a pain scale of 8/10 – so we know they are in high level pain – but functioning with it…. and maybe that’s their norm – they are used to high pain levels.

Others say the pain is stopping them doing thing sand they don’t like it – but their pain scale is 2 or 3/10 – so to them its a problem even though its low level – its interfering with what they do…. and maybe they are used to being pain free.

We are not here to judge what happens and what number you are – that’s your domain – what we DO want to do is change what that number is and dial it down!

Many people get a little grumpy about having to relay where they hurt, why they hurt , what makes it worse and what makes it better….. but its all great info that we actually¬†NEED¬†because to manage back pain we first need to know not only what’s causing it – but whether or not it’s¬†IRRITABLE.


IRRITABILITY refers to what happens when you aggravate your back.

Lets start with a standard 5/10 pain.

You get moving, you exercise and your pain level goes up to 8/10.

Now is that a problem – well of course – would we stop you doing things – well that depends on its IRRITABILITY again…let me explain.

You do 5 mins of running for example and your pain goes up to 8-9/10.

You rest for 10 mins and it goes back to 5 – is that an issue and would we stop you doing stuff – maybe not – it settles quickly and goes back to it’s standard level – it’s not that irritable.

NOW – if you take another example – you start again at 5/10 – you walk for 5 mins and you stop because the pain is 8/10 – now that pain will stay for 3 days and gradually subside but it’s taking 3 days to get back to 5/10 – that’s an irritable back – that’s something we know if we flare that up – you’re sore for 3 days – and that we take seriously – would we push you – hell no. We’d start small and layer in. We work out what your trigger is and work to improve.

Now the former where you’re better after 10 mins rest – well hey we’re happy to look at pushing that a little and testing limits ( within reason of course!) because we know we can settle it quickly and it doesn’t last long.

That’s the point of all the questions when you attend for appointments…. and it guides us as to what we can do for you.

So if you’re worried about your back and the pain level – make a note of your pain level – what’s your ‘normal’, what does it go up to and why and when, BUT most importantly – HOW LONG does it take to get you back to your ‘NORMAL’ level – that’s where the real information lies!

A low level pain, that flares and takes days to settle would cause us more concern and make us treat it differently to a high level pain that flares but settles back down to its normal higher level quickly.

Now look at your pain – have you been overly conservative with it,or have you been trying too hard to push it? There’s a whole heap pf info you need to be taking into account when we deal with back pain. If you’re not getting manage well – maybe look at your aggravating factors and see if you can do something about them – do them less?

Look at what you do when you’re really sore – what helps you? Maybe do that more?

Again without assessing someone we can’t say what would work for you, as there is no cookie cutter solution – it’s based on what we find – but hopefully some of these guidelines can maybe get you starting to think more about what you do and when and why.

Hope that makes sense! x

Call us 9306 8819 if you’re ready to make that shift and manage your pain.

Back Pain. Can’t Move well? What would you write to your younger self?



About Saree Hewlett (135 Articles)
Saree has 20 + years as a physio, training in the UK and completing her Masters in Manual Therapy in Perth, UWA. She has integrated Pilates into her practise having trained in the Polestar method and currently owns and runs two Studios in Perth's Northern Suburbs. A previous international Artistic Skater she understands the needs of sports people and also those suffering from chronic pain and reduced function - we all want the same thing - to be the best we can be! She is married with two active young boys!

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