When Fear Worsens Back Pain

Are your emotions influencing your pain? Studies suggest that our mental health plays a role in our experience with pain, particularly in people with musculoskeletal symptoms like back pain and whiplash.

Although depression has been linked to back pain, you don't have to be clinically depressed to have your mental health affect your recovery from an injury. A new study found that in people with low-back pain, psychological symptoms can actually affect muscle functioning in the lower back.

"This provides preliminary support [of] an interaction between biological and psychological features of LBP [low-back pain], suggesting this condition may be best understood if these domains are not considered in isolation," wrote lead author Nicholas V. Karayannis of the University of Queensland in Australia.

Back Pain and Fear of Movement Study

Nineteen patients with low-back pain filled out questionnaires about their mental health, pain catastrophizing, fear avoidance beliefs, and fear of movement (kinesiophobia). In one test, participants were shown photographs of people performing different activities and were asked to rate how harmful or painful they believed that activity would be.

Next the participants were wired up to a device that allowed researchers to track minute changes in the trunk muscles. Researchers were interested in measuring how well the muscles could react to shifts in weight and balance.

They hypothesized that people with more psychological symptoms would have stiffer trunk muscles, poorer function, and depression. They were surprised to discover that trunk stiffness was related to some--but not all--- of the psychological symptoms evaluated. Fear of movement was most closely linked to greater stiffness when participants responded to a forward disturbance in weight. Other factors like pain catastrophizing, depression, and disability were not significantly associated with stiffness, and none of the psychological factors were related to damping (the body's ability to respond to velocity).

Researchers proposed that there may be "other ways the human system responds to catastrophizing and disability, which are not represented or manifested through these mechanical behaviors."

They concluded that their findings provide preliminary evidence of a link between the psychological and biological factors of back pain, and stressed the importance of addressing both concerns simultaneously.

How Active Rehab Can Help

Active rehabilitation treatments, like exercise therapies and chiropractic adjustments, have been shown to be effective for relieving back pain and preventing chronic symptoms. These treatments can help you restore mobility and regain confidence as your spine and muscles heal. Cognitive behavioral therapy can also be beneficial for back pain patients, since research suggests that a combination of CBT and exercise is as effective as lumbar fusion surgery.