Chronic back pain is a complex condition that involves more than just the physiological structures surrounding the spine. It also involves the mind. If you have severe back pain that won’t go away despite treatment, it is recommend1 that you address your mind as well as your body.
How can your mind affect back pain? One reason is that psychological distress has been linked to a greater likelihood of both getting back pain and having a slow recovery. For instance, a study found that people who tended to “catastrophize” (meaning they assumed the worst in any given situation) had significantly worse back pain. Another study found that people with higher levels of anger and psychological distress also reported higher levels of chronic back pain. These and other findings underscore the need for a holistic view of back pain. We must recognize that it can involve much more than mere muscle and bone.
Most people are familiar with the “fight-flight-freeze” response. When confronted by a threat—be it physical or emotional, concrete or imagined—noradrenaline and adrenaline are released.
- These and other related hormones trigger a complex cascade of reactions. This leads to a state of physiological and psychological hyperalertness.
- The difficulty comes when this heightened state of “red alert” becomes our default setting.
- Stress is an inescapable fact of modern life.
- We now know that if we’re hyperaware of and hyper-responsive to the multitude of stressors we face on a daily level, we start to “burn out.” This causes us to become susceptible to a number of ailments, including depression and heart disease.
- On the musculoskeletal level, the fight-flight-freeze response causes muscles to tense in preparation for action.
- If this response is not deactivated, muscles can go into painful spasms.
While stress-relaxation techniques can’t make a tense situation disappear, they can help you consciously release any muscle tension you may have accumulated in anticipation of or response to the situation.
Here are some techniques to consider:
- One breathing technique that can quiet the fight-flight-freeze response is known as “2:1 breathing.”
- Try a pattern of inhaling to the count of three and exhaling to the count of six.
- Repeat several times.
- Begin by either lying or sitting down.
- Do several cycles of 2:1 breathing.
- Once you feel relaxed, conduct a full mental sweep of your body. Think of it as though you are undergoing a deliberate and complete X-ray.
- Go slowly but steadily, noting any areas of tightness or tension.
- Once you’ve finished the scan, return to those tight or tense areas and let your attention linger there.
- Consciously “breathe into” those areas for several breathing cycles and imagine the muscles relaxing.
- The body scan takes time. But if done on a regular basis, it can help you become aware of the early warning signs of an impending back attack.
- In particular, it can help you become aware of your individual “signal spots.” These are the places that hurt when your back first begins acting up before a full-blown attack strikes you.
- You can then take action, pacing yourself as needed.
This has been found to reduce stress and counteract the fight-flight-freeze response. One meditation technique is known as “taking the one chair.” Imagine yourself in a room in which there is only a single chair. Sit on the chair and observe your thoughts and emotions pass in front of you. Remember that you are occupying the only chair in the room, so your thoughts have no place to rest. Allow them to come and go without getting caught up in them. Then watch them as the thoughts glide out of the room.
Exercise is also a potent stress reducer. Most helpful are meditative exercises. Such exercises include:
- Tai Chi
Be sure to ask your doctor for guidelines relevant to your individual condition, just in case you should steer clear of a particular type of exercise.
Another approach to consider is seeing a therapist for cognitive behavioral therapy (CBT).
- A study review2 found that CBT is moderately effective at reducing low back pain in the short term.
- This type of therapy is aimed at modifying the thought patterns and emotional reactions a person has toward the experience of pain.
- Believe it or not, learning to practice thoughts like “Yes, I am feeling pain right now, but that doesn’t mean everything is hopeless” can actually make the subjective experience of pain less distressing and more manageable.
- American Pain Society
- N. Henschke. Cochrane Collaboration, July, 2010.