What Your Back Pain Is Telling You

Maybe it's time to listen to your back pain.

Posted Sep 11, 2016

I am recovering from back surgery (a microdiscectomy). I ignored my pain when I should have listened. I feel worried, perhaps absurdly so, about the backs of others. So much so that upon waking from surgery one of my first thoughts was to write a post about back pain in the hopes of sparing others the hell I experienced.

Here are some of the things I think your back pain may be telling you.

1. You need to address ignored emotional or relationship problems, and/or better manage your stress.

Some believe back pain is a somatic symptom created by the unconscious to distract us from emotional issues that we want to repress. Physician John Sarno says that tension from internalized pressure and rage leads to oxygen deprivation of the muscle and that’s where the pain comes from. I suppose it’s possible that unexpressed emotions can seek expression in our bodies, or that we can generate pain to force changes that are consciously unacceptable to us. At the very least, poorly managed stress and unaddressed relationship or emotional problems can lead to muscle tension and subsequent back pain.

It’s a good idea to consider possible emotional causes of your back pain. And if you’re stressed, more effective coping strategies will surely help. Problem-focused coping strategies involve addressing the actual source of the stress (like cutting back on your work hours, changing jobs, or ending a relationship). Emotion-focused strategies, like meditation, exercise, and healthy eating, are about increasing resilience so we can better weather stress. A good counselor can help.

2. You need to lower your standards or adjust your goals and give your body more rest and recovery.

My early pain signaled injury and overwork. I needed to rest and heal. But I stubbornly refused to let go of responsibilities, lower my standards, pull back on my care of others, or make time for treatment. My condition worsened to the point where surgery and a long recovery were the only effective treatments. You too may be stubbornly refusing to reduce the activities that are worsening your condition and preventing recovery. I would just tell you to snap out of it, but you may need cognitive behavior therapy (CBT) to treat the stubborn thinking leading to injury and resistance to self-care and treatment.

3. You need to adjust your body mechanics and your physical environments.

Back problems often arise because the environments in which we live, work, transport, or play don’t support good body mechanics or otherwise increase physical stress on the spine. Ergonomic adjustments, such as shock-absorbing floor mats, lumbar support for our car seat, ergonomic furniture, and reconfiguring physical spaces so we can work or hobby without spinal compression, can prevent and reduce back pain.

The way we stand, sit, and carry out tasks, and even just too much sitting, can also compress our spinal discs. Learning good body mechanics is sometimes the key. A good physical therapist can advise. Many people benefit from reducing sitting and getting up every 30 minutes for a short walk or stretch that elongates and decompresses the spine. Improving posture can make a big difference too.

4. You need to improve your physical health and conditioning.

Being overweight can lead to spinal compression and being out of shape can lead to a weak stomach and back muscles, which also strain the spine. A weight loss or exercise program may be what you need to reduce your back pain. One recent study found that exercise was the most effective way to prevent a recurrence of back pain. If you smoke, quitting may also help since smoking dries out the discs, leading to compression.

5. You need medical attention.

I know a handful of people for whom back pain was their first symptom of cancer or osteoporosis. In my case, unremitting leg pain was a symptom of a herniated spinal disc that was pressing on a nerve root. No amount of physical therapy, meditation, medication, chiropractic care, epidural injections, or ergonomic adjustments could take care of my problem once that happened.

Your back pain may be telling you any or many of these things. The benefit of listening is that by taking control now you can avoid the extreme loss of control that comes with severe back pain. You may never need surgery or pain medication if you improve your health practices and body mechanics, consider ergonomics in task environments, and address stress and your emotional issues now.