Joan’s Struggle with Back Pain

There is good evidence that many health conditions are linked to unresolved emotional issues, and back pain is no exception. So after our best efforts, a patient sometimes discovers that, until he or she tackles a difficult emotional situation, remedies remain elusive. That’s exactly what happened to a patient I’ll call Joan.

Joan had been nearly immobilized by back pain for a year and half before she came to see me. Despite surgery and monthly steroid injections, Joan’s back pain was as bad as it had ever been. Her doctor had essentially given up on her, treating her with prescription-strength pain relievers that left her in a fog most of the day. “I just can’t live this way anymore,” she told me on her first visit.

There was nothing in Joan’s medical history to explain the onset of her back pain, so I asked her what she thought may have caused it. Had she fallen down, been in an accident, or been moving heavy objects around? Joan couldn’t think of anything. “It just seemed to start after I’d taken my youngest son to college in New York,” she recalled. “I was on the plane coming back here when my back started aching so badly, I was nearly in tears.”

As we continued talking, I learned that Joan’s husband of 27 years had divorced her earlier that year, leaving her alone and lonely. That, coupled with the fact that her three children no longer lived at home, seemed to coincide with the timing of her back pain. A number of studies show that the sometimes vague, difficult-to-treat ailments like back and joint pain, low energy, and sleep difficulties are commonly found in depressed patients.

When I brought up the emotional aspect to see how Joan responded, she agreed immediately. “I’m terribly lonely and probably depressed, even though I don’t like to admit it,” she explained. “And I can see how that might be connected to the pain, simply as a way of getting attention.”

Fortunately, Joan did not resist my suggestions to try counseling. She found that a combination of journaling about her emotions, going to group therapy, and making an effort to engage more often socially finally eliminated the pain. “It makes perfect sense that emotional issues would find a way to get our attention, even if it means making us physically sick,” she told me last time we visited. “I’m just glad to live in a time when these kinds of connections are taken seriously. It’s surprisingly easy to fix once you understand what you’re dealing with.”

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