Why pain isn’t always just caused by a physical injury.

Mental health and back pain are the top two causes of sick leave in the workplace.   They can often be seen as two separate things but there is a growing awareness that they are interlinked.

In my work, as well as in my own personal experience, I see incidences of physical symptoms being caused by both psychological and physical issues.  As I child I experienced the feeling of a blockage in my throat, affecting my ability to swallow food.  My parents divorced while I was young and this issue would occur during various stressful incidences, disappearing soon after.  I couldn’t work out what was causing this and it is only as an adult that I was able to look back and realise that it was the psychological pressure.  Indeed, it has a name – Globas sensation.

Funny, now I work with people in business,  I see all the time that people get physical symptoms but the power of the mind may well be an underlying factor.

There is a lot of research showing that many physical symptoms can be caused by stress and I can clearly see when there is a psychological influence affecting a person’s ability to get out of a cycle of pain.  Indeed, once you have been suffering pain for a while and not having a diagnosis, battling to find the root cause, it can start out being physical, before becoming exacerbated by stress, frustration and vice versa.   Even as an adult now, when I have had occurrences of back pain, it is hard to personally identify how much the power of the mind is having an influence.  This has included instances of piriformis pain, which would often flare up when I was under pressure – when something was literally being a pain in the backside!

I therefore see that back pain is caused by three factors, either in isolation or as a combination of any the following:

  1. Physical, such as an injury or bad posture over many years
  2. Illness, medical or idiopathic condition, including inflammatory diseases like arthritis
  3. Psychological stressors/stress

With up to 9 million people suffering back pain in the UK, it is an interesting debate as to whether most of these people could be helped before they reach chronic pain stage and get caught in a cycle of pain, with the body creating a learnt response.  It has been shown, that with the right attitude or help, that a back pain sufferer has an 83% chance of returning to work within the first 6 weeks of an episode occurring.  If this then becomes chronic and they don’t return to work within 6 months, this percentage reduces to as little as 50% or less.  Support back to work and access to the care that is right for their particular condition is crucial.

But in every instance, there is a different set of circumstances that lead to the onset of pain and the hard part is that it requires bespoke care to ensure a rapid recovery.  So how do you know whether you need to treat a physical or psychological cause or both?

Last year my daughter was ill.   The symptoms mimicked a psychological illness and the real underlying physical causes were hard to identify.   However, we were lucky and finally, after 7 months, managed to get a proper diagnosis and treatment, through sheer persistence driven by an instinct. She is now fully recovered.

Our bodies and minds are so interrelated it is extremely hard to identify the correct approach, sometimes you do have to trust your instincts.   Indeed, your belief system and psychological state have been found to be important predictors of whether you are going to end up disabled by your pain.  Everyone is different and so you are actually the best person to know how to help yourself, identifying through research and specialist support the most applicable proactive pathways to recovery.    For long term recovery, I believe all of the following are important

  • See a doctor to rule out any medical causes
  • Take responsibility for resolving your own issues
  • If you need to take medication for early pain, quickly learn other ways to reduce it
  • Seek treatment and request positive messages and help with identifying further routes to recovery (ie physiotherapy or osteopathy)
  • Gentle exercise and movement (such as walking, pilates or yoga)
  • Ensure your workstation is ergonomically set up to reduce risk of further injury and stop undoing all of the good work above as soon as you sit at your desk.

Back pain all too often is the accumulated effect over many years of build-up of tension and wear and tear.  This is why it is the innocuous event such as taking the turkey out of the oven when the back just ‘goes’.   So the lesson is, don’t ignore your bodies early warning signals, listen to that stiff shoulder or back and correct your habits accordingly.  We do tend to batter our backs, thinking that it doesn’t matter, we don’t have pain at the moment so why worry.  But if you, for instance, continued to drive your car ignoring the need to put more oil in engine, what would happen?  You can indeed get away with it for a while before it will start to have an effect.  And when it does, the fix is that much harder.

So if you see a physiotherapist, do continue to do the exercises and follow their advice.  Don’t just do them for a short while and give up as soon as you get better.   Check your posture (slouching is not cool in the long term), stay hydrated, take standing breaks, do regular exercise and eat well.

I would be very interested to hear more personal stories, what have you found that works best in your journey to recovery?