Are back problems psychologically correlated?

It’s 50% biological and 50% psychological

For many, “this kind of pain is treated by a good dose of contempt and some aspirins,” explains Dr Éric Gibert, rheumatologist. That is, until the day comes when we can no longer manage it.

It is not psychosomatic…

…when backache is diagnosed during a biological check-up, and is relieved by treatment. Whether it is a slipped disc, sciatica, or inflammatory rheumatism, it is clearly a physical problem. Even if the pains emerge following an upheaval (divorce or involuntary unemployment), their origins are sometimes purely mechanical. “In front of any situation which disrupts our rhythm, the body has to adapt itself”, explains Dr Gibert.

It is psychosomatic…

…when there is a gap between the results of the medical imaging and the intensity of the pain. Or when, at the point of examination, the patient’s pain varies according to whether or not he/she is distracted by what the doctor says or does. “Those signs are easily detectable,” explains Dr Françoise Margaine, rheumatologist. At this stage, we know that medicines or physiotherapist sessions will not be enough to defuse the pain. “When it becomes chronic, when it lasts three months continuously, it is a strong signal,” adds Dr Éric Gibert. “In 80 % of the cases, there is an essential emotional part.”

The doctor tells us about patients for whom the body unlocked itself to not have to undergo a traumatic situation; for example, a boss who requires too much, or being forced to have sexual intercourse. In these literally blocked people, the lumbago becomes a real strategy of protection. Other incomprehensible pains, which can also be insensitive to the morphine, are a way to catch the attention. The occipital neuralgia (characterised by chronic pain in the upper neck, back of the head and behind the eyes.) or pains in the coccyx are expressions favoured for psychosomatic disorders. When all treatments fail, doctors update these mechanisms, by simply asking: “how do you live with this pain?”

What to do?

Talking is essential. The dialogue, the revelation of the problem and its resolution can be guided by a doctor, a hypnotherapist or a psychologist. For situations where a pre-existing pain manifested itself or became more marked under the influence of an emotional context, the work lies in managing it. Osteopaths, physiotherapists, and also thermal cures, can help our body to stop suffering.

Stéphanie Torre

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