The Psychology of Back Pain

In the posts How I Figured Out the Cause of My Back Pain and Back Pain and Learned Helplessness, I briefly mentioned the psychological aspect to back pain. I want to elaborate on this topic because the first time I was exposed to this idea I misunderstood it.

Dr. John Sarno specializes in patients that deal with chronic back pain. He believes that stress is the major cause of back pain. When we go through periods of chronic stress, the brain uses a diversion tactic to protect us emotionally. That diversion is to manifest REAL PHYSICAL pain, often in the lower back region. The pain is real. It is not in our heads. The roots however are psychological.

The Mindbody Prescription: Healing the Body, Healing the Pain by John E. Sarno M.D. is a better book than The Divided Mind. I have not read his 2010 release Healing Back Pain.

The stresses in life are supposed to episodic and not chronic. Episodic stressors teach us how to both physically and mentally overcome life’s challenges. We are wired for success. In earlier days, we would respond quickly to a threat such as a tiger by picking the right tree to climb and acting fast. Once the tiger left, the stress was removed and life returned to normal. Modern life stressors such as long commutes or bad bosses are predictable and chronic. The brain still craves success, so it diverts our attention away from the stressor. Enter back pain.

How does stress manifest as true physical pain? According to Dr. Sarno, the brain uses mild oxygen deprivation to the regions where the pain will surface. It doesn’t have to be the back. It could be your neck or feet or something else. If you are solving the pain problem physically, you can try and block the pain signal to the brain via painkillers or push oxygen back into the regions of pain (massage, acupuncture, chiropractic).

However, validating a pain with psychological roots with a physical response is not the best long term solution for back pain. In fact, it often just makes the problem worse later. We get addicted to the pills and massages because of the very relief they provide, but because the stressors remain, the pain will eventually resurface. The worst part is it validates a helplessness strategy for dealing with our pain. Pain + $$$ = no pain. Being healthy and pain-free is your birthright. It should not a consumer choice.

Photo by Tony Hall

It took me a while to fully grasp the concept of psychological stress as the root cause of back pain. It wasn’t until I studied where I was at emotionally during each of my back pain flare-ups did it all make sense. Dr. Sarno says that people with the most back pain tend to be perfectionists or have control issues. The brain is just trying to emotionally protect you from an environment for which you have no control over.

What is the first step in eliminating back pain? Stop validating the physical symptoms and begin reflecting on the psychological causes. I’ll go into greater detail on strategies that I’ve used in a future post. In the meantime, read the post Perspective…back pain on Conditioning Research. Also, read the comments.