Back pain and mental health

Psychological wellbeing can affect every area of our life, but we often forget about the close connection between chronic back pain and mental health. Carrying emotional baggage can weigh heavily on the back, and certain personality types feel the strain more than others. Dr Peter Barth, Mayr Physician at Park Igls and a specialist in psychosomatic medicine, shares some observations and top tips from his experience, advocating a holistic approach to treatment. Park Igls Mayr clinic helps patients with back pain through tailored programmes that treat the psyche and the body as two parts of a whole. The antidote to back pain often begins with psychological support.

‘When the psyche suffers, so do the back, muscles and posture. The psyche always looks for an outlet in the body, and these are the areas that tend to offer the least resistance. Injuries, trauma and emotional pain; feelings of guilt, failure, overwork and fear are inevitably reflected on a physical level unless they are dealt with quickly,’ according to Dr Barth who has a special interest in psychosomatic medicine. ‘The gravity of unprocessed trauma cannot be emphasised enough as it’s often the cause of chronic pain.’

There is an inseparable connection between body, mind and emotions. The fact that this is recognised in western medicine is thanks to physician and scientist Thure von Uexküll. Born in 1908 in Heidelberg, the founder of psychosomatic medicine disagreed with the dualistic paradigm of medicine that treated ‘the sick body but not the psyche’ or ‘the suffering psyche but not the body.’ This dualism reflected a mindset that is still widespread today. Psychosomatic medicine on the other hand holds the more holistic view that the psyche is always manifest in the body. Dr Barth remarks: ‘Observe the posture of people suffering from depression – slumped shoulders, a stooping gait – in contrast to someone with a confident, upbeat attitude, which is reflected in their posture and movements.’

Human beings are more than the sum of their parts. The Park Igls Mayr clinic practises integrative medicine, and, with decades of practice behind him, Dr Barth understands the complexity of pain: ‘Someone who is complaining of back pain, like tension in the neck and shoulders and lumbar spinal syndromes, is usually carrying an emotional burden.’ If the psychological symptoms go untreated, negative feelings like aggression, anger, frustration, pain, stress etc. are never resolved, and soon find a way to manifest themselves in the body. Chronic anger, for instance, means the body is constantly in fight mode, ready to attack or defend.

Dr Barth believes: ‘Personality definitely has an effect on back pain.’ People who set themselves standards that are high, or even too high, belong in the high-risk group. As do alpha types and workaholics who neglect to ensure a healthy work-life balance and ignore the physical indicators of stress. Then there are the copers: they equate showing emotion with weakness. Finally, the avoiders crave harmony and are unable to deal with conflict. Ignoring our personal boundaries is counterproductive and damaging to health. ‘We can deal with a certain level of stress. But chronic stress is a dangerous condition,’ Dr Barth warns. It is important, therefore, that therapy and prevention focus on self-awareness and mindfulness.

Pain is the body’s way of warning us that something is wrong. Patients should therefore seek medical advice as soon as they feel restricted, notice physical-psychological symptoms and/or begin to have trouble sleeping. Initially, a patient needs to be assessed with regard to structural changes (e.g. of the spine), postural imbalances, trapped nerves, muscle tension or stiffness etc., then therapy can begin. ‘During the therapy it is important that we acknowledge the patient and their situation as a whole. That means it should be led by experts from multiple disciplines: doctors, psychologists, physiotherapists and personal trainers. The approach taken at Park Igls is holistic, which means we form a biological, psychological, social and mental picture of every single patient and customise the therapy to suit them,’ Dr Barth explains.

The interactive effect of psyche and body is highly complex, which is why Dr Barth insists it needs to be a matter for consideration across all medical complaints. There are no simple answers when it comes to this interplay between mind and body, and for pain therapy to be successful in the long term, it must involve physical activity. ‘It’s important to shake off passive illness behaviour and get on with the business of life. The fear of back pain often results in avoidance behaviours. Not exercising enough and adopting unnatural adaptive postures can also lead to new pressures, resulting in even more pain; it’s a vicious circle. The various programmes and methods at Park Igls show our patients how they can improve muscle tone, strengthen the nervous system, relearn the beneficial interchange between stress and relaxation, use their breath positively, and stimulate their bodies to encourage self-healing. We also share with them the secret of autoregulation using the six principles of Modern Mayr Medicine: cleansing, resting, learning, supplementing, exercise and self-discovery. You have to get active, otherwise nothing will change. Except perhaps the pain will get worse instead of better.’

Photo credits: Park Igls, IStock