How Stress Affects Back Pain: A Psychological Perspective

As a Pain Doctor will tell you: “psychological factors not only affect back pain, but also how much the pain impacts our life. – Depressive symptoms can make back pain worse & increase the disability associated with back pain. And people with back (or neck) pain are more likely to meet criteria for common mental health problems, including major depressive episodes & anxiety disorders. The coexistence of such issues with back pain is linked to impaired quality of life & increased risk of long-term back pain [1]. – And this is why Pain Specialists provide multidisciplinary solutions – they treat patients holistically, & regularly work with a team of specialists in a broad range of fields

Did You Know?

Both acute and long-term back pain can be linked to psychological distress in the areas of stress, worry and anxiety; as well as the sufferer being depressed, or feeling sad or discouraged. Indeed, research shows that it is commonplace for psychological distress to come to the fore as a result of aspects of acute back pain – even when the individual’s symptoms do not last for long, and are not classed as medically serious. Of note, these manifestations of feeling distressed,are connected to our body’s neural and hormonal processes which work to protect us. However, as Pain Doctors usually explain to their patients, substantial studies indicate that :

“Through these processes, distress usually makes pain worse over time, & increases the disability caused by pain. This means that when people with back pain are also distressed, treating their distress should also help their back pain” [1]

How Self-Compassion Can Help the Stress From Back Pain

Self-compassion, one of the newer forms of self-therapy, has been of great interest to Pain Doctors. This is because when it comes to sufferers having to deal with back pain, learning to be self-compassionate is regarded as a positive thought process. – Something which empowers the individual to adjust to their back pain, especially in regards to the psychological impact of blame and self-criticism.

As Pain Consultants often tell their patients: there are numerous ways for sufferers to self-regulate their back pain when they are journeying through the inevitable emotional, social, and physical challenges of this debilitating situation. In the context of suffering, one of the self-regulating techniques is the form of self-compassion which includes endowing one’s self with understanding and kindness.

“Preliminary uncontrolled trial evidence demonstrates that brief self-compassion training is associated with reduced pain & disability, increased self-compassion & interoceptive awareness, decreased evoked pressure pain responses, & significant changes on fMRI in response to pain anticipation” [1].

Moreover, the good news is that the aforementioned results are inline with other research reports, all of which indicate that self-compassion is negatively linked to stress, depression, anxiety, stress, pain interference, and social and work adjustment in individuals who have chronic pain [1]. In other words, self-compassion negates stress, and all the other listed negative effects.

Why Some Pain Doctors Recommend CBT

When people with back pain visit, or have an online consultation with a Pain Specialist, once the latter has reviewed their medical history, asked them pertinent questions, and undertaken any necessary tests and scans in order to give an accurate diagnosis, the Pain Doctor will then devise a Holistic Personalised Treatment Plan. Alongside conventional treatment and therapies, the plan may also include sessions with a CBT (cognitive behavioural therapist). This is because , in regard to back pain: “a meta-analysis showed that CBT, compared to no treatment or other guideline-based active treatments, leads to long-term improvement in many dimensions of the pain experience, including pain intensity, disability and quality of life” [1].


[1]. Internal Association For the Study of Pain (2021). “Psychology of Back Pain.”