Focusing on Mind-Body Connection Could Help Back Pain

Man with back pain

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Key Takeaways

  • Researchers looked at a 3-month program that used mindfulness and anxiety reduction to reduce chronic back pain.
  • Participants saw significant relief during and after the program while more than half had zero pain 6 months later.
  • There is a connection between stress and back pain, so people with chronic pain may want to address their stress as a way to find pain relief.

Despite being the leading cause of disability worldwide, chronic back pain is often a difficult condition to treat. But a pilot project detailed in the journal, Pain, suggests there may be value in a program that focuses on the mind-body connection.

When it comes to chronic issues, back pain is particularly thorny because in many cases, a structural issue cannot be identified, says study co-author Michael Donnino, MD, a physician in the departments of critical care and emergency medicine at Beth Israel Deaconess Medical Center (BIDMC). For example, there may not be enough damage to the spine to warrant the level of pain reported by the patient.

“This type of pain may be driven by stress or repressed emotions,” Dr. Donnino notes. “The exact mechanism remains unclear, but an analogy could be made to other known effects of acute emotional states on physiological changes.”

About the Study

After recruiting 35 participants with chronic back pain, physicians from BIDMC used a 12-week program that included mindfulness-based stress reduction with sessions of 2 hours each, done once a week for 8 weeks. The participants also attended one full-day session (retreat) lasting for six hours.

Participants also attended sessions twice a week focused on reducing anxiety and worry for 4 weeks. Another aspect of the program was returning to physical activity in a meaningful way. At the end of the study period, there was a significant improvement in overall function, as well as lower pain levels and reduced anxiety.

They found that the program was highly beneficial for treating back pain even compared to standard care, and the results have potentially lasting effects. About 64% of participants reported remaining completely free of pain 6 months after the program ended.

Pain and the Mind

The current paradigm of pain management focuses on the physical origin of pain, Dr. Donnino says. When none seems to exist, it is called non-specific back pain, and it may be coming from a psychological process.

For instance, feeling embarrassed causes capillaries to dilate and that brings blood rushing to the face—also known as blushing. Similarly, excitement or anxiety can cause changes in the digestive system, called “butterflies in the stomach.”

Michael Donnino, MD

When patients recognize this relationship between the mind and their physical pain, this sheds new light on the issue.

— Michael Donnino, MD

To a much more serious degree, sudden traumatic news can result in what is called cardiogenic shock or “broken heart syndrome.” Much like some forms of back pain, there may be no physiological reason for this type of shock to occur, but emotional upset might prompt it anyway.

For back pain, addressing the stress rather than the pain it is causing might go a long way toward alleviating both issues, Dr. Donnino suggests.

“When patients recognize this relationship between the mind and their physical pain, this sheds new light on the issue,” he says. “That has the potential to be highly beneficial.”

Decades of Evidence

The potential association between emotional health and back pain specifically has been studied for decades.

For example, a study published in July 2021 in Scientific Reports looked at 8,473 participants with and without low back pain. Interestingly, 357 of those in the chronic low-back pain group and 1,697 reporting no back pain stated that they were under a high degree of stress. Those with the pain had much higher stress levels overall, enough that researchers recommended stress awareness and management as part of back pain treatment.

Even workplace-related back issues, which are often thought to stem from poor ergonomics and too much sitting, could have a psychological component, according to Gabriele Buruck, PhD, a professor at the Technische Universität Dresden in Germany.

She and fellow researchers looked at 18 studies involving over 19,000 people and found that those who felt less supported at work were considerably more likely to have chronic back pain.

Gabriele Buruck, PhD

We were able to show that factors like workload, job control, and social support significantly contribute to the development of [chronic back pain] as well.

— Gabriele Buruck, PhD

"Back problems are often attributed to incorrect posture or sitting for too long,” Dr. Buruck says. “But we were able to show that factors like workload, job control, and social support significantly contribute to the development of [chronic back pain] as well."

Although this program is not yet available to the public, taking any steps to address emotional health issues may be useful for treating persistent back pain, she says. That may include approaches like mindfulness and stress reduction, as well as cognitive behavioral therapy and work changes.

What This Means For You

Stress and lower back pain may fuel each other, research suggests. That means treatment of chronic back issues may benefit from stress reduction as well. If you are receiving treatment for chronic back pain, talk to a healthcare provider about the impact of stress and how you can apply techniques to reduce pressures in your life.


4 Sources
Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Donnino MW, Thompson GS, Mehta S, et al. Psychophysiologic symptom relief therapy for chronic back pain: a pilot randomized controlled trialPR9. 2021;6(3):e959. doi:10.1097/PR9.0000000000000959

  2. Vahdatpour C, Collins D, Goldberg S. Cardiogenic shock. J Am Heart Assoc. 2019 Apr 16;8(8):e011991. doi:10.1161/JAHA.119.011991

  3. Choi S, Nah S, Jang H-D, Moon JE, Han S. Association between chronic low back pain and degree of stress: a nationwide cross-sectional studySci Rep. 2021;11(1):14549. doi:10.1038/s41598-021-94001-1

  4. Buruck G, Tomaschek A, Wendsche J, Ochsmann E, Dörfel D. Psychosocial areas of worklife and chronic low back pain: a systematic review and meta-analysisBMC Musculoskelet Disord. 2019;20(1):480. doi:10.1186/s12891-019-2826-3

By Elizabeth Millard, CPT, RYT
Elizabeth Millard is a freelance journalist specializing in health, wellness, fitness, and nutrition.