Working with Pain
A New Understanding of Back Pain

Back pain affects nearly all of us one way or another, whether it is a sudden flare-up which stops us in our tracks or having to deal with persistent pain which prevents us doing the things that make us tick. It can often vary from day to day, making it difficult to plan things. Most of us will know of friends or relatives who struggle to live an active life due to back pain, and it’s common to feel helpless in being able to assist them back to the life they had before. But the way we help people recover from back pain is changing, thanks to a large body of research and which has helped to re-write the rules on persistent back pain.

This approach acknowledges that biological, psychological and social factors can all play a role in the experience of back pain. You never get one without the others; they always link together. People with back pain are much more likely to benefit from treatment if we consider all three of these factors in tandem. Until fairly recently back pain treatment did not focus on such a broad view but it is now widely accepted that there is an association between psychological, biological and social factors whenever pain is experienced

From a biological perspective we know that many changes occur in our body when we experience back pain: involving our central nervous system (that is the brain, spinal cord and autonomic part of the nervous system), our endocrine (hormones) system, our immune system and our musculoskeletal system (our muscles, tendons and joints). These biological changes become more pronounced as back pain persists and play an important role in maintaining back pain and poor function, long after we had expected to recover. We still don’t fully understand all the myriad of biological changes that occur when we experience back pain but researchers continue to reveal new and exciting theories relating to how these changes link to the pain experience. Having an understanding of this will help you to recover

From a psychological perspective, we know that when people experience an episode of low back pain, there are different psychological responses. For example, some people become fearful of moving, and worry they might cause more damage to their back. Some people avoid activity because they fear they may get a further disabling flare-up of back pain if they push their activity too much. These are normal and logical psychological responses to an episode of low back pain; but if they persist and are left unchecked will contribute to persisting back pain and poor function.Some people become overwhelmed with negative thoughts relating to their bad back and develop low mood or anxiety linked to their back pain. They then get stuck in a vicious cycle of fear, avoidance, negativity which they struggle to recover from. It can be very difficult to get out of this vicious cycle on your own. Having an understanding of this will help you to recover

From a social perspective, we know that the circumstances in which you live and work can influence your recovery. If people around you, including friends, family, work colleagues, health professional or bosses incorrectly view your back pain as a problem which needs protecting or as something that will end your career, it will have a significant negative impact on your ability to recover. We may read things in the media or on-line about back pain which influences what we do about it, but that information may be wrong and can help to maintain our back pain and poor function, rather than help us to recover. Or you may be in a medical system with long waiting lists, and don’t get the chance to get the right advice about how to recover from back pain until several months pass. At this point, many biological and psychological changes may have taken hold and you find yourself in a cycle of persisting pain and poor function. Understanding how this links to your back pain will help you to recover

So to be able to effectively help yourself restore function and quality of life when back pain persists, it is really helpful to understand how these three systems are combining together to maintain your pain problem. 

WMUK are at the forefront of helping to get this new understanding of pain out to both individuals that may be experiencing pain as well as Professional working to help people with persistent pain problems

WMUK are proud to introduce David Rogers co-author of 'Back to Life' to their consultancy team
Training for Health Care Professionals

Understanding how to successfully assess, treat and manage employees with back pain should be a core skill for OH professionals, as back pain is the leading cause of long term disability and work loss in the UK, posing a huge burden to the individual, industry and the economy. Central to this understanding is ensuring that OH professionals develop a thorough knowledge of the role of psychological factors in back pain. 

Emerging evidence over the past few years has helped us to understand back pain from a much broader perspective, and we now acknowledge that psychological factors can play an important role in both short and long-term workplace absence due to back pain. By learning how to assess these factors, we are able to identify aspects of employees back pain experience that may be holding up their recovery and preventing them getting back to, or remaining at work. This type of approach, using cognitive behavioural principles is now recommended in clinical guidelines for the treatment of back pain, and the research base for this approach is substantial, with studies demonstrating improved outcomes when compared to usual care.

We are excited to have teamed up again with The@Work Partnership in developing a training programme that will launch in September 2017. This new one day workshop from the At Work partnership looks at how to assess and treat psychological obstacles to recovery in back pain to improve consultations and employee outcomes. Watch out for details to be announced soon!

David Rogers

David Rogers is a chartered physiotherapist with over 20 years’ experience of helping people with musculoskeletal pain to recover function, return to work and regain their quality of life. After completing a degree in Sports Studies, in 1994 he qualified as a chartered physiotherapist from the University of Birmingham and in 2010 gained his Masters degree in Pain Science and Management from Keele University.

He has worked in many different healthcare environments, including the NHS, the occupational health industry and sports medicine, and is currently playing an active role in large research trials relating to back pain. Within occupational health he has worked as a physiotherapist in a variety of industries including manufacturing, travel and tourism, food and beverage, public utlilities and within the healthcare sector.  He has played a leading role in an NHS Trust, establishing a functional restoration service for people with back pain, combining both physical and psychological treatments within an interdisciplinary team.

His work is focused on applying a biopsychosocial approach to recovery, using cognitive behavioural principles aimed at maximising recovery. As well as his clinical work, David is a lecturer to undergraduate and post-graduate physiotherapy students. He recently has had his first book published by Random House entitled ‘Back to Life: How to Unlock Your Pathway to Recovery When Back Pain Persists’ 

BACK TO LIFE- How to unlock your pathway to recovery when back pain persists

'Back to Life" By David Rogers and Dr Grahame Brown (Vermillion Trade Paperback)

The revolutionary way to defeat persistent backpain and get your life back on track.

Back pain is very hard (often impossible) to diagnose and to specify, hence heavy painkillers are thrown at people. But the only way to beat the pain is to understand it.

Based on cutting-edge research into back pain and the psychology of pain itself, David Rogers and Grahame Brown have have developed the pioneering Biosychosocial approach: 

Bio- how your body processes pain; what physical triggers you have and why; where your body holds pain;

Psycho- where your pain is coming from; what exactly your pain is; the power of your mind to deal with and stop pain; and;

Social - all the environmental factors that will contribute to your back pain, and how, why and when to change them.

Based on this revolutionary and already hugely successful approach, Back to Life offers a whole new way of dealing with back pain: understand the psychology of pain; debunk the myths; find the source of your pain; manage your pain - including all the emotions and anxiety that go with it; master exercises and stretches; identify and solve the social factors; and get lasting relief.

Working Minds provides a range of cognitive behavioural self-help material, which can be downloaded in a PDF format.
These include:



testimonials CBT has been integrated in to all aspects of the occupational health practitioner’s work in ... Sharon Whitehouse, Occupational Health Manager
testimonials Sharon and Alan’s training in cognitive behavioural practice and their ongoing supervision ... Anita Ross and Hayley Arnold, Case Managers
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