Treatment 1 – Understanding the Problem & Pain Science
Session Goal: Introduce the structure and function of the lumbar spine, explain why sub-acute low back pain happens in active service members, and correct common pain misconceptions.
Explain the Anatomy and Physiology (Foundational Education)
Lumbar Structure Overview: Five vertebrae (L1–L5), separated by discs that act as shock absorbers. Supporting ligaments and muscles (multifidus, erector spinae, quadratus lumborum, abdominals) maintain movement and posture. Nerves in this region control lower-body motion and sensation.
How It Works: The spine balances stability and flexibility. When structures are strained or fatigued, pain and stiffness may occur.
Describe Why Military Members Are at Higher Risk
Repetitive heavy lifting, running, load carriage, and gear wear cause mechanical stress.
Limited recovery time and fatigue increase micro-trauma and inflammation.
Harsh environments and sleep deprivation delay tissue repair.
Explain the Sub-Acute Phase
Pain lasting 1–3 months = sub-acute phase. Tissues are healing but may still be sensitive. Crucial time to prevent pain from becoming chronic and more difficult to treat.
Some inflammation persists, and muscle guarding is common.
Neuromuscular control may be impaired, increasing stiffness.
Suggested Therapist Script
“You’re not in acute injury anymore, but your system is still protecting the area. Our work focuses on helping those protective muscles relax and remodel."
Address Common Misconceptions about Pain
Myth 1: “Pain is normal in the military.” → Pain signals overload and shouldn’t be ignored.
Myth 2: “Pain = damage.” → The nervous system can remain sensitive even after healing has occurred.
Myth 3: “It’s all in my head.” → Pain is real but influenced by stress, mood, and environment.
Myth 4: “Only medication fixes pain.” → Multidisciplinary care is most effective.
Patient Homework / Reinforcement
Reflect on personal pain triggers and beliefs.
Track when pain improves or worsens with activity.
• • Encourage rest–activity balance (avoid full rest days unless necessary).