New study shows link between back pain and anxiety
Chronic pain, especially back pain, is one of the largest and growing medical problems in the western world.  A study by Dr Victor May who is a Professor of Neurological Sciences investigated the hunch that psychological factors play a central role in pain. The researchers wanted to understand why people recovered physically from injuries would still feel pain. It didn’t make sense.
Dr May and his colleagues successfully pinpointed where physical pain and psychological pain meet, thus causing chronic pain. The part of the brain which is the ‘control centre’ for emotions is called the amygdala, is also directly connected to the spinal cord. The researchers found that the amygdala expressed more PACAP (peptide neurotransmitters) whenever the patient encountered either physical pain or emotional stress. This part of the brain treats biological and psychological factors as equally important.
May’s study concluded that when pain increased, so did psychological stress demonstrated through behaviours stemming from anxiety. They also found when the pain barometer was lowered, so did the exhibition of distressed behaviours.
This discovery should have a tremendous impact on patients with bad backs, arming medical practitioners with additional information for providing more effective treatments. “By targeting this regulator and pathway, we have opportunities to block both chronic pain and anxiety disorders,” said Dr May. “This would be a completely different approach to using benzodiazepine and opioids. It’s another tool in the arsenal to battle chronic pain and stress-related behavioural disorders.”
The University of Vermont is not alone in its quest to solve chronic pain for millions around the world. If we cross the Atlantic Ocean and visit the city of Birmingham we will find an exciting publication that delves into the science behind back pain and psychology as well as identifying successful treatment methods.
David Rogers, a qualified physiotherapist and researcher, has recently published Back to Life: How to unlock your pathway to recovery (when back pain persists). He says, “research has identified that psychological and social factors such as the way patients think about their back pain, as well as depression and anxiety are stronger predictors of long-term pain and disability than physical factors.”  Rogers’ book is here to explain how an injury puts the brain into fight-or-flight mode, and the challenges in deactivating it.
The book tells us about the healing program he has been running successfully at the Royal Orthopaedic Hospital in Birmingham for over half a decade. It has seen amazing results that include one study of 85 participants where 92% were not using pain medications after nine months of treatment. The program involves two group sessions a week where people learn breathing techniques, cognitive behavioural therapy as well as stretches and exercise that they can call on whenever they feel the need.
There are lots of questions about the relationship between biology and psychology that we will be able to answer as our technological advancement and scientific knowledge increases.
