Is back pain actually all in the head?

Lower back pain has many causes, from relatively minor such as muscle sprain to more serious, such as a fracture or problem with a disc. While back pain sufferers do indeed have a debilitating physical ailment, for many people there may also be a psychological dimension that defines the extend and impact of the pain. Dr. Eugene Carragee, study lead author and associate professor of functional restoration at the Stanford University Medical Center in California and his team compared the results of magnetic resonance images and vertebral disc tear tests among 96 patients who had known risk factors for disc degeneration. Such tears have traditionally been thought to directly cause lower back pain, with ruptures in the discs that cushion contact between the vertebra bones resulting in painful pressure being placed on sensitive nerves. Researchers were surprised to find that those patients with disc problems were only slightly more likely to have back pain then those without any disc degeneration. They also noted that 25% of those who did have disc problems had no lower back pain at all. Carragee and his colleagues concluded that torn discs are not always painful, and not all lower back pain is a result of a torn disc. From psychological tests, the researchers also found that pain is actually more accurately associated with the patient's state of mind - with depression and poor coping skills often being a better predictor of back pain than disc damage. The researchers therefore cautioned that treating a patient for emotional and perceptual concerns may be more beneficial in reducing lower back pain than the more standard invasive, costly, and oftentimes unsuccessful back fusion surgery option.

SOURCE/REFERENCE: Spine, December 2000 issue (in-process)