ask dr. read      Idaho Statesman columns      new articles      biography      formal resume      philosophy      services offered      contact dr. read      psychology links      other links      forms      pictures		Back Pain May Be Exacerbated by Emotional Factors by James M. Read, Ph.D. Anyone who has ever had any backpain has probably heard about the link between stress and/or emotions and this kind of discomfort. Some doctors who treat back pain think that psychological methods should be involved in the treatment of every case of back pain. That may be going a little too far even though cases with a purely physical etiology can probably be helped by stress reduction and other psychological means. But not all othopedic specialists agree, especially when it comes to backs. It's because stress and anxiety can produce muscle tension and tightness that some think it is a major contributor or even cause of back pain. And indeed, deep muscle relaxation, along with stretching and muscle toning exercises can do a great deal to reduce or even eliminate many types of back pain. Anxiety and stress and pain become a vicious cycle with some. They worry about the pain, the pain causes more worry, and the worry increases the pain. That's why all pain clinics have programs with a psychological component. They teach anxiety and stress reduction along with physical therapy and other mechanical approaches. When I was a young fresh-out-of-school psychologist I worked in a medical clinic where the orthopedists had us see all of their back surgery candidates. They'd come into the hospital, have a mylogram, and while they were flat on their backs following the procedure we'd go see them and do a psychological evaluation. The surgeons were interested in screening out patients whose pain appeared to be predominently caused by stress and psychological rather than physical factors. Two recent studies have addressed the question of back pain and the link to psychological distress. Workers at a Boeing plant in Everett, Washington were given extensive physical and psychological evaluations . It turned out that people who were unhappy with their work, but prone to deny distress were the ones most likely to have back pain problems. Researchers also found that people who were happy with their jobs were incapacitated for a shorter period of time when they did have back problems. Another study showed that anxiety, depression and pessimism seemed to predict back pain. But researchers again had trouble separating cause from effect, and physical problems from psychological. The bottom line, according to researchers from the University of Washington, is that psychological factors aren't the whole story. But, if you're vulnerable to back pain it is worth considering problems at home and at work as possible contributing factors. Do what you can to relax and reduce stress and anxiety and depression. And do the exercises your doctor or physical therapist precribes for you. James M. Read, Ph.D. Clinical Psychologist  Originally published in The Idaho Stateman newspaper (Boise, Idaho) March 26, 1994 For more information, or to contact the author (that's me!), write to James M. Read, Ph.D., jread@jread.com