Back Pain: Is it All in Your Head?

This is not medical advice. If you’ve recently had an accident, go see a doctor.

Back Pain Gaslighting

Some doctors and books on back pain will have you believe your pain is all in your head. This is called gaslighting.

You know there's a problem, but other people will try to convince you everything is fine and you're imagining or creating it out of nothing.

"Chronic pain is always complex and never in someone's head. Years of imbalance and often imperfect loading and/or inadequate recovery lead to tipping points." (Rehabilitation of the Spine by Craig Liebenson, p.165)

Some Truth in the Claim

If you're experiencing a high-stress situation, your back pain is likely to increase, but not because you're imagining it, instead because there are real changes that happen with higher stress:

• You're less likely to prioritize your health

• Exercise is likely less

• Good food is not as common

• Poor posture and slouching are more likely

• Being more sensitive to the regular pain you feel is probable.

• Catastrophizing your situation is common with higher stress

While the stress can be a cause for worsening symptoms, it's possible to reduce its effects by prioritizing your health, having some movement non-negotiables, and developing better posture habits.

Back Pain Solution

"A thorough assessment reveals the mechanism of pain." (Dr. Stuart McGill via YouTube)

After you’ve visited a McGill Clinician to rule out more serious forms of back pain, the next step is to identify what causes you pain so you can stop “picking the scab” and allow your tissues to heal. Back pain is almost always made worse by one particular motion, posture, or load that the individual unknowingly repeats.

If you have back pain, you probably have a good idea of what makes it worse. Begin by starting a list to describe your pain. Some people avoid making a list because they think they “already know what hurts,” but this arrogance will see that a solution is never found. To heal yourself, you must study yourself and practice pattern recognition.

Here are a few questions to answer as you compile your list.

• Does the pain get better or worse depending on the time of day? Does your pain gradually build throughout the day or is it greatest upon waking?

• Are there particular activities or situations when you notice your pain more? Things like bending forward or to the side, sitting in a car or on a plane, rolling over in bed, reaching, or sneezing?

• If sitting causes you pain, how long until you notice?

• Do you feel better or worse after exercising? Do particular exercises make your pain better/worse?

• Does your pain worsen when stress increases or with the changing seasons?

• Are certain muscles habitually tight or do you notice areas of your body that store tension?

Write down details to every pain you feel because these are pieces of the puzzle that is your chronic pain. Look for patterns in postures and movements so we can avoid triggering your pain and allow your body to recover. It’s a miracle how quickly you can heal yourself once you stop triggering your pain and adopt the right protocol.

Bed rest is usually recommended for acute low back pain, but rest is not a permanent solution. Rest to give your body a chance to heal, not for fear of the pain. One study has shown that 2 days rest is as effective as 7 days [Source].

Pain-free movement as soon as possible following injury accelerates healing of muscle and bone. [Source] Light walking, stability exercises, or isometric muscle contraction can help to stimulate blood flow and the healing process. Sauna or hot tub can aid recovery, but sitting on the couch with an ice pack for 20 minutes won’t help!

Conclusion

85% of back pain is categorized as nonspecific, meaning there isn't a direct cause for pain. Doctors will use fancy terms like degenerative disc disease, but what they're really saying is they don't know why your back hurts. In order to identify the cause of your back pain, begin by studying your body.

Education should be the foundation of medicine. Unfortunately, many doctors and people who want to help are woefully ignorant to the multitude of back pain causes.

If you've read this far know that your pain is NOT ALL IN YOUR HEAD! There is a real and functional cause to your pain, and by identifying your pain triggers you can begin to eliminate your symptoms and return to living a pain-free life.

If you want help on your journey of overcoming your back pain, schedule a consultation to work with me directly.

Hope this helps! - Tom