Back pain is an epidemic in this country, with 8 out of 10 people complaining of some degree of back pain at one point in their lives. It is generally accepted that emotional stress or psychological factors can make any back pain or problem worse. In fact, in several recent studies, psychological distress proved to increase the risk of both developing back pain and of experiencing a slow recovery. However, the concept of “stress-related” back pain takes this idea one step further. The diagnosis of stress-related back pain assumes that psychological and emotional factors, and not physical injury or degeneration, are the primary cause of the pain.
Stress-related back pain often takes on the pattern of a vicious cycle of pain. The patient’s fear and anxiety about the condition, leading to more pain, the greater pain leading to decreased physical activity, the reduced physical activity leading to weakening of muscles and more stress, and so on and so on…
John Sarno, M.D., a physician, and professor of physical medicine and rehabilitation at New York University, has recently developed an actual diagnosis for stress-related back pain, which he terms, “Tension Myositis Syndrome” (TMS). Dr. Sarno believes that the majority of back pain cases being treated by the medical community today primarily using physical treatments are actually stress related.
Tension Myositis Syndrome (TMS)
In TMS, as described by Dr. Sarno, back pain is not the result of mechanical or physical effects but is caused by pent up feelings, emotions, and other subconscious issues, particularly feelings of anger, rage and frustration. In addition, he says that there are personality types that are predisposed to developing TMS, such as those who feel:
- Driven to succeed
- They have great responsibly
- Very self-conscious and self-critical
- Compulsive and driven to perfection
You may recognize this as the “Classic Type A” personality. According to Dr. Sarno, when these personality characteristics combine with stress – back pain, or TMS is the result. At this point, we should point out that while TMS and/or stress-related back pain is a very real phenomenon, the reader should not self-diagnose, and assume that this is indeed the cause of your back trouble.
There very well could be a physical problem, such as a tumor or injury, and a diagnosis of Stress-related back pain should only be made by a qualified medical professional.
Self-Help Techniques and Treatments for Stress-Related Back Pain
By now it should probably come as no surprise that in general the treatments for stress-related back pain all begin with an overall acceptance of the reality that stress and a kind of “mind-body connection” is responsible for your condition. From that point, there are treatments that may be prescribed by your healthcare practitioner, along with many “self-help” stress reduction techniques that can get you well on the way to a pain-free life.
As you might imagine, Dr. Sarno’s approach focuses on dealing with the repressed emotions and feelings of anger and rage that he feels are the root cause of stress-related back pain. More conventional practitioners suggest a multidisciplinary approach that takes all stress factors into account such as:
- Physical—including overall condition, muscular strength, nerve irritation, etc.
- Emotional—including depression, repressed anger, and anxiety
- Cognitive—thoughts of negativity, pessimism, and hopelessness
- Environmental—relationship issues, financial problems, workplace stress, etc.
The multidisciplinary approach would then see which of these factors are or are not, contributing to the back pain and prescribe treatment modalities for each, which could include pain medications, physical therapy, or manipulative therapies to ease pain and relieve physical symptoms. Counseling and/or antidepressants may be recommended to help with emotional and cognitive issues. Complementary and alternative techniques for pain management and stress reduction may be recommended including but not limited to:
- Chi Gong
- Massage Therapy
- Acupuncture and Acupressure
On the other hand, Dr. Sarno’s approach would strictly concentrate on techniques to release the “bottled up” emotions causing unconscious tension. In this approach, the person with stress-related back pain is not treated physically, but psychologically through sessions of group and individual counseling, emphasizing the psychological and emotional factors as the root cause of the pain, all designed to get the patient to “think psychological, not physical” when back pain occurs. In either approach, it is important that you also do what you can to reduce stress and break the cycle of pain.