The pain involved in caring

We all know that back pain is incredibly common with one study in 2000 reporting that almost half of the adult population in the UK, 49%, experienced back pain for at least 24 hours in the year. Unfortunately for carers this is much higher, with a study in 2011 showing that 70% of them experience back and shoulder pain.

These individuals are actually saving the NHS and the local authorities significant amounts of money as a result of their care-giving, yet the onset of persistent pain can seriously affect their lives as well as the person they are caring for.

The widespread belief is that pain in carers is due to physical ‘injury’ as a result of the manual handling that often becomes a part of their caring role. Even when no physical abnormality can be found for their pain, their diagnosis is generally put down as ‘non-specific’ low back pain and the belief is still that there must be a physical cause to it. care-giving, yet the onset of persistent pain can seriously affect their lives as well as the person they are caring for.

Evidence to dispute a physical cause

Interestingly, despite the limited amount of ‘lifting’ allowed in the public and private sectors since the implementation of the EEC Manual Handling regulations in 1991, there continues to be an increase in the number of people being diagnosed with chronic back pain. In fact in 2012 one study reviewed 18 trials to ascertain the impact proper manual handling techniques had on prevention of low back pain and found there was none.

This might come as a surprise to many people, unless they are aware of the plethora of research over the past few decades demonstrating that there is no link between posture, structure and biomechanics. Add to this the studies that clearly show a link between psychosocial stresses and the onset of back pain and it should encourage everyone to begin to question the generally accepted belief that pain must have a physical cause.

One of these studies that can then be related back to carers’ situations is a study published in 2000. Researchers followed a group of trainee nurses throughout their 3 years training and the most consistent factor found to predict back pain onset was psychological distress, rather than anything physical.

Another more recent study looked at the psychological, social and mechanical predictors of back pain. The findings were that ‘the most consistent predictors of back pain were lack of decision control, empowering leadership and fair leadership.’

Pain as a manifestation of the build up of unresolved inner turmoil

Although a carer might choose to care for their loved one, there are usually challenging circumstances surrounding that decision. They often feel undervalued and the situation itself often results in the lack of being able to have much say in what is happening. Inner turmoil can also result from the carer’s conscious altruistic wish to help and put the other person first and the conflicting, often unconscious, need for their own self-care needs to be satisfied.

These conflicting needs usually go unrecognised, or maybe the carer feels they are selfish to even think of putting themselves first for once or to feel resentful. Unfortunately by bottling up these feelings, they can build up and eventually when an outlet is required, they can manifest in physical symptoms, such as back pain.

3 simple tips to help prevent stress-induced pain:

1) Where possible the carer needs to find some time for self-care each week, when they can do something purely for themselves, even if it’s only for an hour or two. Obviously external support might need to be arranged in order for this to happen, whether this is help from family and friends, or the local authority to provide regular respite.

2) The carer ideally needs to acknowledge openly how they really feel deep down, even if it is just to themselves, rather than bottling it up (which is ultimately what causes the problems). This can be done simply by scribbling on paper, which they can then destroy. If they feel guilt for how they feel about expressing these feelings, then this needs to be openly acknowledged too. They can then put things back into perspective and carry on as before, but this allows them to ‘defuse’ the emotional ‘pressure cooker’ building up inside.

3) Social interaction is important, so being able to have friends round, or go out with them, can help carers cope better with all that is expected of them.

Do you have any experience of being a carer and any tips to pass on?