The Back Pain Loop

Too common

Back pain is really common in our country. Georgetown’s Health Policy Institute has some statistics about the frequency and impact of this condition, but if you’re suffering from chronic back pain, there’s just one thing you want to know: how to get it to stop.

there’s just one thing you want to know:
how to get it to stop.

In the midst of figures about how many days of work people with back pain miss, the Health Policy Institute points out that

Substantially larger proportions of adults with back pain, compared to those without back pain, report feeling sad, worthless, or hopeless. Almost three-quarters — 72 percent — of those with back pain report that such feelings have interfered with their life, compared to 61 percent of those without back pain. People with chronic back pain report significant levels of psychological distress, including feelings of anger and depression, while people who have suffered an acute episode of back pain are less likely to report these feelings.

Georgetown University Healthy Policy Institute, emphases mine.
Data from four national surveys of US civilian non-institutionalized population

Correlation or cause?

So researchers see a correlation between chronic back pain and a lot of negative things. But they don‘t say that there’s a causal relationship, ie, that developing chronic back pain leads to feeling sad or angry, like this:

They also don’t say that the negative feelings cause the pain, like this:

So what do you think? Here’s an impossible question: Is your back pain depressing you and leaving you irritable and angry, or does your back hurt as a result of how awful you feel every day?

I hope you answered, “both!”

The pain cycle

You’re correct. In fact, back pain is part of a predictable cause and effect loop, involving both physical and psychological elements (because the brain is the body and the body is the brain–more to come on this). Here’s the pain cycle depicted, with its two integrated loops:

In simplified terms, pain generates more pain. Here are some other renditions of the pain cycle, one that focuses on sleep and energy and one that highlights lifestyle factors.

However you draw it, pain makes people feel bad. If you’re in pain and also feel bad emotionally, you don’t want to do anything. Inactivity makes the pain worse and further lowers your mood. Two vicious, life-sucking loops.


But you don’t have to be stuck. Cycles can be interrupted. The body is enormously capable of healing. Tell me about your pain cycle, and let’s get started reversing it.