Chronic Low Back Pain: Is It All In Your Head?

Back pain is one of the most common and disabling conditions we see today.

The most frustrating aspect is that most back pain is nonspecific- we cannot figure out what exactly causes it! However, what we are now learning from research is how you THINK about your back pain translates physically into what you actually FEEL.

Related: Core Strengthening Exercises for Back Pain Relief

Have you ever heard the phrase “cells that fire together wire together”? Essentially this is saying that the more you use certain parts of your brain with specific thoughts and actions, the more habitual those thoughts and actions become. Our brain is what we call “neuroplastic”- it is constantly changing and our thoughts directly affect what parts of our brain are more active and developed than others.

Related: How to Eliminate Back or Sciatica Pain

When you experience pain, your body tissue experiences a stress or strain. When a threat threshold is reached our bodies signal to our brains that something is going on. Once this information reaches our brain, changes start to occur. Recent evidence has shown that the areas in our brain necessary for motor planning, inhibition, and spatial reasoning start to decrease in cell bodies and activity during episodes of chronic pain. We lose efficient ability to execute movement or even have an accurate representation in our minds of the area of our body that is in pain. Research has also shown that we lose the ability to modulate the pain and this can lead to an enhancement of sensations that we perceive as painful.

Something that is important to understand is that pain is a multi-dimensional experience- it can be generated in the body AND the brain.

The truth is, pain cannot exist outside of our consciousness. Our brains define what we perceive as a threat and therefore painful. Just like Pavlov’s dog, the experience of chronic pain can become a conditioned response, associated with movement that is not normally painful. If we always associate bending over with pain, we begin to anticipate this sensation and create it ourselves, even if mechanically our backs are not being stressed or strained. We amplify sensation and stimulate our nervous system in such a way that pain is now being created in our brains rather than outside of it.

Related: Why Back Pain is So Common

So how do we change this? The beauty of neuroplasticity is that if our brains can change from pain, we have the capability to change them back to a state where pain is not amplified. Physical therapy plays a large role in this process. By working with a therapist to experience movement in a pain free way, you can re-teach your body and re-wire your brain to understand that certain movements do not have to be painful. This, in combination with methods of meditation, mindfulness, or relaxation can actually change the way your brain processes pain. Finding empowerment through the idea that you can control how you perceive your own pain is the first and most important step towards healing and recovery.

Chronic Low Back Pain: Is It All In Your Head?

By Karah Charette

Back in Motion® Physical Therapy – South Portland, Maine

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