Woman with back pain
Back Pain

Mental Treatments for Back Pain

One of the most common disabilities in the U.S. is low back pain, according to the Harvard Health Blog. More than 80 percent of people will have this pain at one point or another. The most frequent causes include injuries to a disc, lifting heavy objects and sciatica, the health blog says.

But patients’ response to back pain can differ widely depending upon their “psychological attitudes and attitudes and outlooks,” according to author Srini Pillay, MD, writing in the Health Blog.

Pillay points out that when movement limited, that can cause distress, which can in turn worsen the pain. And, he says, if you are anxiety-prone and habitually expect the worst, that can make your pain more debilitating. “Those psychological vulnerabilities can change your brain and intensify the pain,” he writes.

He explains that patients with these “pre-existing psychological attitudes” often have “abnormalities in the regulation of your brain’s chemistry (particularly dopamine), and the usual brain functions in emotional control, anxiety, and attention are also disrupted.”

The result, he says, means that you focus only on the pain, and it becomes “all-consuming.”

Additionally, Pillay says, your brain can actually be rewired by the pain. “When pain first occurs, it impacts your pain-sensitivity brain circuits. But when pain lasts, the related brain activity switches away from the ‘pain’ circuits to circuits that process emotions. That’s why emotions like anxiety often take center stage in chronic back pain. And it’s why emotional control becomes that much more difficult.”

But that doesn’t mean all hope is lost. Pillay says some non-medical therapies can help with back pain, especially mindfulness-based stress reduction (MBSR) can help reduce back pain and also improve emotional control. He says that an eight-week course in MBSR may improve anxiety and depressive symptoms, too. This technique, Pillay says, activates a “brain relaxation pathway” and helps you focus on your breathing.

Besides MBSR, cognitive behavioral therapy can help. CBT, as it is known, can be practiced in group or individual sessions. And hypnosis can be another pain reliever, as can progressive muscle relaxation.

But Pillay emphasizes that dealing with back pain via mental techniques doesn’t mean the pain “in your head.”

“In this day and age, writes, ‘mind over matter’ makes little sense. ‘Mind’ includes ‘matter,’ especially when you consider that the physical ‘matter’ of the brain plays a major role in mindset changes. This is especially true when it comes to the brain-based changes related to low back pain. To that extent, changing your mindset and brain biology can help your brain — and lessen your pain.”

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