If you have an illness, it will be harder to heal if you’re in emotional distress. Many experts agree that psychological factors can even make any existing pain worse. Back pains are no exception. There is even something called “stress-related” back pain, in which emotional and psychological factors play a major role.
Back pain that is related to stress is considered a psycho-physiological or psychosomatic illness, which means its physical symptoms are believed to result from emotional or psychological factors. These factors may initiate and/or maintain the back pain.
Tension Myositis Syndrome
Dr. John Sarno, a specialist in rehabilitation medicine who died in June 2017 a day before his 94th birthday, conceptualized stress-related back pain, which he called Tension Myositis Syndrome (or Tension Myoneural Syndrome) or TMS.
Sarno theorized that a majority of back pain cases that were being treated using physical treatments or “organic” approaches were actually related to stress. He believed that many people could overcome pain through by acknowledging that it is rooted in their emotions, and instructed many of his patients to keep a journal or have a go at psychotherapy.
Sarno’s TMS and its treatment methods – mind over matter – became very controversial not only in the medical but also in the psychological community. For one, Sarno didn’t test his ideas with controlled studies. He said he would rather spend his time seeing patients and helping them recover.
However, Sarno’s methods have achieved success. Many back pain sufferers have been healed by the doctor, including famous personalities such as Larry David and Howard Stern. Some of his theories are now being validated scientifically, particularly the idea that there can be an emotional factor for back pain. It has become accepted that chronic back pain is a biopsychosocial condition, in which both biological and psychological factors play a role.
Stress-related back pain: The cycle of pain
Most theories around stress-related back pain mention that it has a pain cycle, which is continuous and is worsened as the pain results in the patient feeling anxiety over day-to-day activities. This cycle of pain that back pain sufferers go through is characterized by the following:
- Becoming unnecessarily limited in day-to-day functions and leisure activities
- Decreased activity is due to fear of injury and pain
- The fear is worsened by advice from family, friends and doctors to take things easy because of some diagnosis that may not even have anything to do with the back pain
- Because of the lack of physical activity, the body weakens, leading to more back pain
- The cycle continues, with the patient experiencing more pain, fear and physical weakening as well as psychosocial reactions such as anxiety, depression and isolation.
Multi-disciplinary treatment for stress-related back pain
Back pain related to stress cannot be addressed through medical intervention only. Healing requires a multi-disciplinary approach. First, the physical, emotional, cognitive and even environmental factors that may be causing or worsening the pain need to be evaluated. Only then can a treatment program be developed for each patient.
A treatment program may include physical therapy, medications such as antidepressants, pain management techniques and counseling, among others.
If you think your back pain is mostly or primarily influenced by stressful situations, it’s recommended to see a specialist right away so your condition doesn’t get worse. Try to avoid things that trigger your stress and seek appropriate help.