10Psychosocial factors Involved in Low Back Pain

The International Association for the Study of Pain defines pain as ‘an unpleasant sensory and emotional experience’. Whilst we as health professionals have a good grasp on the biological mechanisms involved in the conduction of pain signals and the mechanisms by which they can be influenced through pharmacological and other means, we often forget that pain is a highly subjective and personal experience and always has an emotional dimension that we need to appreciate. Despite this, many doctors and therapists wrongly attribute pain as being either physical or psychological. There are many instances especially for low back pain sufferers where the physical findings which may explain a patient’s symptoms have been exhausted and so symptoms are neatly explained away as being psychogenic in origin. Factors that are involved with keeping patients chronically disabled with their back pain are psychosocial and not pain, in the main. Most low back pain studies show that the main emotions experienced include anxiety, increased bodily awareness and fear are helpful in an acute injury as a threat warning, however, these accompanied by depression and anger are maladaptive in sub-acute and chronic pain. These emotions are heightened by their pain and disability and if left to run out of control, can aggravate and perpetuate the pain and anxiety experienced by the patient and become part of the problem.