3 Things You Didn’t Know Were Causing Back Pain

An increasing number of studies show that in most cases, pain in your back does not indicate something physically wrong. Research suggests that chronic back pain isn’t actually the result of injury or illness. Instead, it could surprisingly be caused by our thoughts, feelings, and resulting behaviors. Read on to discover what doctors say is the best way to combat pain caused by psychological factors. 

The second leading cause of lost work time, chronic low back pain (CLBP) is one of the most common conditions in people worldwide. Being that it is often unyielding to medicinal treatments, it can become costly and disabling. It has become necessary to find alternative methods of safe and effective treatment for back pain. This article will discuss these alternative treatments and more importantly, the little-known psychological factors that can make back pain chronic.

Negative Thoughts

We all experience pain and have probably felt some irritation or anger at our condition and the pain it causes. This is totally normal, but if those thoughts start to consume your mind, it can affect your body. Believe it or not, there is plenty of evidence to suggest that the more you are bothered or troubled by pain, the longer it will take to recover. 

Defined as “pain catastrophizing”, some of us tend to assume the worst about our experience with pain, magnifying its threat. It shows up as rumination (“I can’t stop thinking about how much this hurts.”), magnification (“I am worried that something serious is wrong.”), and helplessness (“It’s terrible and it’s never going to get better.”)

According to the International Association for the Study of Pain,

“People who lack confidence in their ability to do things despite pain, or their ability to manage their own pain, are typically more disabled by it and in more pain, than those who are confident they can do things  despite their pain.”


Believing that back pain is a sign of serious injury often causes people to avoid physical activity altogether out of fear that they will make it worse. Unless your back pain is caused by injury and in the process of healing, avoiding physical activity is counterproductive. This can be described as “fear-based avoidance” and as shown in the Fear Avoidance Beliefs Model, it can lead to cycles of increasing pain and disability.

Fear-based avoidance sounds like “It’s not really safe for a person with a condition like mine to be physically active”. It has been said that the fear of pain, injury, or reinjury can be more disabling than the pain itself.

Note: Just as avoidance behaviors can perpetuate chronic pain, so can the opposite habits. It has been said that overperforming and “dysfunctional persistence” with physical activities despite severe pain can hinder the healing process and lead to increased pain and functional limitations.


Your body tends to interpret stressful emotions as a physical emergency thus chemical and physical reactions take place to try and protect you from harm when you are feeling stressed or anxious. This typically takes place in the neck, shoulders, and down the spine and causes muscles to tighten.

Prolonged tension in these areas can lead to back pain. On the flip side, stress is also a common reaction to suffering from back pain, even when symptoms are not medically serious. It becomes a cycle of pain and stress and they both can get worse over time if not treated. 

How To Treat Psychological Factors Associated With Pain

If you have experienced any of these thoughts or behaviors in response to back pain, you have a higher risk of not recovering as quickly. The early identification and management of these psychological factors have been found to be effective at preventing back pain from becoming long-term.

A study in The Journal of the American Medical Association showed that practicing mindfulness or cognitive behavioral therapy (CBT) works remarkably better than medical care alone to reduce disability and pain-related suffering.


Cognitive behavioral therapy uses a combination of techniques to help identify and correct unhelpful patterns of thoughts, feelings, and behaviors. It takes place in six to eight weekly sessions that aim to help patients become aware of patterns that can trigger pain. CBT can improve your recovery by giving you more productive, less stressful ways of thinking. In one study, 78 percent of people with CLBP reported that treatment was successful and they were able to return to work. 

Mindfulness Training

Most mindfulness-based programs consist of eight weekly group sessions where participants are taught a variety of meditation techniques including daily activities that are easy to practice at home. Meditation helps the mind’s ability to be in the present moment while accepting the experiences of the moment. In terms of pain, it helps you acknowledge and accept physical sensations of discomfort and release the negative reactions associated with it. 

Here are a few quick ways to practice mindfulness when faced with a challenge such as a pain flare-up:

Take a pause. Don’t automatically react to pain.

Take notice of what is happening at the moment. Become aware of thoughts, emotions, and sensations.

Focus on your breathing. Pay attention to the airflow or the rise and fall of your belly with each breath.

Make a mindful decision about, as opposed to reacting automatically about, what to do next (if anything).

Once you become aware of your thoughts and resulting behaviors in regard to pain, you have a greater advantage in overcoming it!

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