Is the stress of lockdown and beyond contributing to your low back pain?
Research over the years has shown that both back pain and chronic back pain are associated with an increased likelihood of depression, psychosis, anxiety, stress, and sleep disturbances.
Lockdown and the lack of certainty about what is going to happen to our jobs long term and all the other aspects of our lives in the times we are living in can mean that we develop depression, anxiety, stress or sleep disturbances too.
So you can see that one impact can easily impact on the other – a bout of back pain plus you feeling more anxious than usual or depressed or stressed can mean that these factors actually get in the way of your physical recovery… this can become a self perpetuating issue. The more you feel pain, the more anxious you feel and in turn the more back pain you feel … and so it goes on and on.
You visit us to help to relieve your pain by physical means but research suggests that people with low back pain that lasts for a long time (chronic) may benefit significantly from help from a trained psychotherapist.
We must remember that our minds and bodies are closely affected, one by the other and not all people respond in the same way. In fact, even if two people have the same level of pain, their responses to that pain can be very different. These differing responses are due in part to different people’s psychological attitudes and outlooks.
Even when you have low back pain that is being medically treated, it helps to understand the psychological factors that impact your pain — and your brain. It also helps to know what you can do about this.
Why chronic back pain is connected to “your head”
When your physical movement is limited, this can cause psychological distress, and the psychological distress can, in return, worsen the pain. Your personal health beliefs and coping strategies can influence both your level of distress and course of the pain. For instance, if you are anxiety-prone, expect the worst, and have catastrophic thinking, this can make the pain far worse. That’s because those psychological vulnerabilities can change your brain and intensify the pain.
Often, if you have these pre-existing psychological attitudes, you also 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. As a result, you can’t control your distress; your become anxious; you expect the worst; and you can’t focus on anything else. The pain becomes all-consuming.
But it’s not just pre-existing attitudes that worsen back pain. The pain itself can rewire your brain. 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 over in chronic back pain. And it’s why emotional control becomes that much more difficult.
How you can help to reduce your chronic back pain
Fortunately, some psychological therapies can be really helpful with back pain. They help lessen pre-existing psychological vulnerabilities, change how you perceive the pain, and also alleviate the psychological factors (such as anxiety and anticipation) that maintain your pain.
The treatment with the greatest supporting evidence (for all chronic pain syndromes, not just back pain) is mindfulness. A recent study demonstrated that a technique called mindfulness-based stress reduction (MBSR) can help to reduce back pain and also improve emotional control by increasing brain blood flow to the frontal lobe.
There are other forms of psychological treatment that can be helpful as well. Cognitive behavioural therapy (CBT) can be especially helpful. You can attend group or individual sessions either in person or via computer. Even a single episode of back pain can benefit from psychological treatments. CBT can also prevent an acute injury from progressing to chronic back pain.
Hypnosis may help relieve the pain as well.
How this clinic can help to reduce the impact of your brain on your pain!
Changing your mindset and brain biology can certainly help your brain — and lessen your pain.
The chiropractors at the Avenue Clinic are aware that our patients with high levels or long duration of pain are at risk for psychiatric disorders that deserve treatment independent of therapies for pain and we have linked with a wonderful therapist, Meredith Plumb.
Meredith has 20 years of psychotherapy experience. Her treatments are by telephone consultations at your convenience. Her expertise is to explore the causes of chronic conditions. Her treatments are client led and you the client choose the duration of the therapeutic relationship.
One hour costs just £40 and how often you consult her is entirely dependent on your needs which you would discuss with her. Don’t think you will have to sign up for months of treatment! Meredith listens to your concerns and your needs and will advise accordingly but how many sessions you have is always driven by you.
If you would like a preliminary discussion to see if she thinks she can help you, please call her on 0161 4851744 or email her at meredithplumb@sky.com.