What is fluctuating back pain?

Physiotherapy in Vernon for Lower Back

Q: I heard a report on the radio that people with fluctuating back pain have the best chance for recovery. What exactly is fluctuating back pain?

A: There are literally thousands of studies done on back pain. What causes it, who will get better, who won't, what type of treatment works best for each type of patient, and so on.

All kinds of variables have been investigated from age to sex (male versus female), body weight, education level, work load, general health, and even locale (rural versus urban setting).

Fluctuating back pain is an actual category first described by a researcher by the name of Dunne back in 2006. In the course of trying to classify or characterize low back pain, there were four categories described: 1) severe persistent pain, 2) moderate persistent pain, 3) fluctuating pain, and 4) mild persistent pain.

The term fluctuating pain was used to describe changes in frequency, intensity, and/or duration of pain. Someone could have severe pain one day, no pain the next, then mild pain escalating to severe again.

Or the pain might be rated as an eight on a scale from zero (no pain) to 10 (worst pain) at one point in time then drop down to a two on the same scale. Those are examples of fluctuating levels of intensity. Frequency (how often pain occurs) and duration (how long it lasts) can also change or fluctuate from day to day (or even within the same day).

It is believed that people with pain that comes and goes (or varies in any way) have a greater chance for recovery because the nervous system is still plastic (changeable). And the evidence from studies so far bears out that theory. By comparison, people with chronic, severe, unrelenting pain tend to experience fewer changes or improvement in their pain levels.

Reference: Oezguer Tamcan, et al. The Course of Chronic and Recurrent Low Back Pain in the General Population. September 2010. Vol. 150. No. 3. Pp. 451-457.

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