The Pain-Emotion Connection continued...
Some people with low back pain magnify their pain until it explodes into something far more profound than it really is -- a tendency known as catastrophizing. Say your doctor diagnoses you with degenerative disc disease. When you catastrophize, a whole range of scenarios runs through your mind. You imagine your back becoming so debilitated and painful that you have to quit your job and stay at home. You even envision a future in which you're confined to a wheelchair.
The physical and emotional toll of living in constant pain leads nearly a third of people with chronic pain to become clinically depressed. About 75% of people who are being treated for depression report physical symptoms, including pain. If pain can lead to emotional distress, the reverse is also true. The more trouble you have dealing with stress, the more likely you are to experience pain. In one small study, patients who were under mental distress or who had chronic pain (not in the lower back) were three times more likely to develop low back pain than those who had better coping skills.
Stress and pain can turn into an inescapable cycle. You're in pain, so you feel stressed and anxious. Stress can cause your muscles to tense up, which ratchets up the pain even more.
Another cycle can emerge -- this one centered on fear and avoidance. "People will avoid activities that they fear might either make their pain worse or [cause them to] reinjure themselves," Schofferman says. Avoiding physical activity will eventually weaken your body to the point that even if you want to finally go out and do something, you won't have the strength to do it.
Treating Your Physical and Emotional Pain
Taking medication or having surgery can address the physical cause of your pain, but if you're anxious or depressed, it won't solve your entire problem. "You need to treat the structural problem and the psychological problem. Both need to be addressed at the same time," Schofferman says.
For people with mild to moderate low back pain, a supervised exercise program may be enough to treat physical and psychological symptoms. "Many times when the person exercises under supervision…their depression improves, their anxiety can improve, and their avoidance improves," says Schofferman. The goal of these programs is to strengthen the muscles of your back and the areas that support your back (such as the abs), and teach you how to do everyday activities -- like lifting and bending -- without hurting your back.