Although there are structural changes such as vertebral misalignment, herniated discs or wear and tear, more than 50 percent of the time mental disorders such as stress, grief or loneliness can be the real cause of back pain. That's because psychological stress can actually cause physical pain.
Stress puts the body on high alert: muscles tense, nerves irritated. In fact, pain serves as an early warning system. But the nervous system can also control pain completely, so it loses its warning function and becomes independent. Nerve fibers then continuously send pain impulses, a state of anxiety persists all the time. When the brain concentrates on this, a so-called pain memory emerges: after about three months, the brain begins to literally internalize pain. It remembers that certain movements can cause pain and become dangerous.
It's a vicious circle: stress causes pain, and pain causes even more stress. The resulting cascade of signals causes the pain to be felt more and more intensely. Many patients experience fear of pain and are spared. But it is this avoidance that can lead to intermittent pain actually becoming constant pain, "chronicling" it.
Multimodal pain management can help break this vicious cycle. In doing so, physicians, psychotherapists, and physical therapists work closely together to develop a multi-week therapeutic plan that includes three areas: Medical treatment including medication, physical therapy, and psychotherapy.
Ideally, specialists will continually exchange views during multimodal therapy. They often report surprisingly quick successes: many patients realize after only a few days that reducing stress can also reduce pain.
Behavioral therapy helps with back pain. An important prerequisite for successful physical therapy is that patients must understand the relationships that make their pain symptoms worse or better. Through therapy, patients regain confidence in their bodies. Those who understand their pain are able to change their behavior and are motivated to do things independently.