Psychological Aspects of Backache

Back is a very special organ. It has certain unique aspects in relation to its structure, function and location. Back is used to support other parts of body and the Loads which are placed upon it for transportation. We think of psychological and social, as well as physical burdens being carried on our backs. In short back symbolises physical strength. Hence the terms unyielding, stiff, unbending attitude are common terms which are used in society by an individual by certain degree of pride and aroma of being a very straight forward, honest, non compromising and a person of firm decision. These terms have originated with particular reference to back  as an organ of execution.   Back is also considered as an organ for protection & defence, perhaps because of natural instinct of putting forward the back if an unexpected attack is to be faced.  Back is also considered as an organ for expression of love & affection. An arm around the waist is universally accepted as an act of romance, love & affection.

Patting on back by a senior or parents will boost the morale of any individual, if he or she has done a reward winning deed. Thin waist symbolises beauty. All these thoughts do prove that there is a special orientation of back in human psyche. It is natural that certain knots develop during the growth of an individual, which manifest as backache, at one time or the other during life time.

Such people can be labelled as, backache personalities.  They are likely to repress their anger and avoid conflicts, traits they share with many victims of peptic ulcer& migraine. In such cases back pain is just tension headache that has slipped down to back.

It has become customary on part of general practioners to label a case of backache as psychological if the patient does not   respond to usual dosage of pain killers and-some vitamin B-complex injection.   But no patient should be labelled as ‘psychological’ unless a very detailed history has been taken & physical examination done. The patient should be thoroughly investigated- even with advanced investigation like MRI, CT scan etc. If, a single examination does not reveal the exact cause of backache, then repeated examinations & investigations should be done. It is found that quite a few cases which are initially labelled as ‘backache of psychological origin’ on careful examination & investigations turn out to be suffering from Tuberculosis & even cancer. The right treatment, if given early, could have changed the entire course of life of these individuals.

Even if the backache is proved to be of 'psychological origin, there is nothing to get disheartened. It is still curable. A psychiatrist should be consulted. Backache  has been observed due to boredom also. A large number of middle aged ladies attend the physiotherapy clinic regularly because they find it an- outlet for their monotonous routine at home. In India most of the middle and higher income group families do not permit their women folk to undertake any gainful vocation. It is taken as a social stigma & a family insult. Sometimes, some people have a heavy emotional investment in continuing their pain.  An elderly lady had been married for decades and had grown up children, settled in Canada. Her husband was always busy in factory. One day while cleaning the ceiling fan she fell down and sustained some injury to the back. Suddenly her husband became attentive to her. She realised that she was rewarded by painful illness. The original injury was healed but she continued to complain of low backache. (She had emotional need for love, care and affection which she got through injury).

Backache can also be a by product of difficulties on job, problems of personal relation or grief over the death of some near and dear one. Such cases of 'masked depression' can go on for years undetected.  Some people tend to be hard driving or exhibit to be pushing forward type but actually lack self confidence, also develop backache as a protective phenomenon to their failure and ascribe their inability to achieve the goal to their backache subconsciously.