2018 Volume 30 Issue 3 Pages 243-248
Low back pain (LBP) and Katakori (stiff neck and shoulders) are two major symptoms in the Japanese population. Common pathologies of LBP and Katakori are: 1) frequent symptoms, 2) disc degeneration is not the only cause of symptoms, 3) psycho-social factors are deeply related to symptoms, and 4) we should consider the whole body pathology although symptoms are local. Common treatments for LBP and Katakori are conservative treatments. Exercise therapy is recommended, and whole body exercise is the most recommended treatment. Exercise-induced hypoalgesia (EIH) is related to the endogenous inhibitory system of pain. The strongest mechanism of EIH at present is the cannabinoid-related mechanism.
Because chronic pain is related to various factors, a multidisciplinary approach involving various pain professionals for analyzing the pathology and treatment is recommended. The central role in multidisciplinary treatment is exercise therapy and psychotherapy. Three important points of cognitive-behavioral therapy for chronic pain are: 1) do not aim for a pain-zero life, 2) do not pursue the original pain source, but cope with the "present" pain, and 3) have confidence that even if pain is present, it is bearable.
