The International Association for the Study of Pain outlines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”
You’re probably familiar with these unpleasant sensations. You stub your toe on the door, half a second of silence follows, then the sharp sensation of pain. But what is actually going on inside your body? Nerves are distributed throughout your body, transmitting and receiving messages from your brain.
Pain is a defensive, evolutionary ability. It produces a response which moves your body away from something which is potentially damaging, such as reflexively pulling your hand off a scorching pan handle.
Gate Control Theory
Formed in 1965, this theory presented one of the first neurological foundations for pain. In terms of pain, large and small diameter nerves play very important roles. These nerves congregate in an area of the spinal cord known as the dorsal horn; here they trigger the release of chemical signals known as neurotransmitters. Transmission cells, also known as T-cells, open the pain gate. Whilst inhibitory cells hold the gate closed.
An area of your spinal cord referred to as the dorsal horn accepts sensory information, for instance, touch, from your body. The data is then processed through two different types of cells, both present in the dorsal horn: transmission cells open the pain gate and allow pain signals to travel to the brain, where pain is comprehended; inhibitory cells keep the pain gate closed and help prevent pain perception.
Together, large and small nerve cells stimulate T-cells. But the large nerves awaken more inhibitory cells. Therefore, if you have more activity in the larger nerves, you will feel less pain, and vice versa.
Understanding how these nerves function allowed the development of pain medication. Some lower the amount of inflammation; others prevent the initial nerve transmission of pain; others request for more activity from larger nerves, producing more inhibitory cells that keep the pain gate closed. Finally, some pain medications lower the activity of the smaller nerves to stop the gate from opening in the first place.
So, we’ve covered how the brain interprets pain signals and that the interpretation varies, depending on a number of different factors. However, your thoughts can have a biological effect on how cells are stimulated too. If, for example, you say, “Oh, stubbing my toe on the door doesn’t hurt that much.” the brain will transmit a signal to the dorsal horn which lowers T-cell activity and therefore will reduce the intensity of pain. The brain has the ability to learn to ignore some types of pain and successfully block its transmission. Think of the people who walk on hot coals or broken glass. Now that’s mind over matter.
Psychology, Stress, and Back Pain
How we think about an event can determine how our biochemistry triggers pain reactions. But can emotional stress or other psychological conditions in and of themselves cause our backs to hurt? Some health experts say yes.
Psychological problems such as the internalization of physical and sexual abuse can result in physical pain. As can chronic stress, rage, and fear. While pain this subsequent pain may be deemed psychosomatic, and may not rooted in physical causes, the pain is very real. The exact same symptoms exist, including tenderness to touch, muscular twinges, and throbbing sensations.
Once people understand that their pain is psychosomatic, they may feel defeated, that somehow their pain does not actually exist. It is. And it is not helpful to blame yourself. Actually, it can make matters worse by generating further stress. Luckily, as a society, we’ve started to understand that the human experience is far more than just a physical one. Thoughts, emotions, life experiences, and spiritual elements all affect our health.
John Sarno, M.D., a physician and professor of physical medicine and rehabilitation at New York University, credits the majority of back pain cases to stress in some form. He is famed for terming stress-related back pain Tension Myositis Syndrome (TMS). Further studies have shown that his psychological approach to back pain relief has been effective in some cases. His treatment regime often involves journaling, meditation, and psychotherapy. While we certainly accept that that some back pain does have psychological factors as its source, very real underlying physical conditions are the common cause. There’s no arguing with the fact that a pinched nerve causes pain.
In addition we suggest adopting a holistic or whole-body approach to pain relief. The mind and body work together. How we feel emotionally will affect our body, and our body in turn will affect how we think. Managing and reducing pain entails understanding both.
Other Non-spinal Causes of Back Pain
The reason behind your back pain may not always be linked to your spine itself. It could be the result of another underlying medical condition. Maybe you have one of these disorders and may not have linked it to your back pain. In any case, it’s a good idea to take a look at the non-spinal causes, not just to rule them out, but to discover whether perhaps they are the cause of your pain. A doctor’s diagnosis for most of these disorders is pretty straightforward.
- Gynecological problems
- Kidney stones
- Bladder issues
- Gastrointestinal problems for example, Crohn’s disease or ulcerative colitis
- Pain from hip problems