Back Pain as a Distraction Pain Syndrome

Abstract

One of the most intractable and expensive problems facing modern medicine today is chronic, nonspecific back pain. The current approach, which attributes the pain to structural problems, is invasive, expensive and not very effective. Based on this fact, along with a growing body of clinical and circumstantial evidence, we believe that it may be time for a paradigm shift in diagnosis and treatment, in which the problem is treated in an integrative fashion as more psychosomatic than structural. Although, in our conception, the pain is both real and ‘physical’, in the sense that it is experienced physically and may involve functional alterations in the affected tissues, we present a rationale that melds the purely ‘physical’ and purely ‘psychological’ conceptions of pain into an integrated model that is clinically significant. We believe that the ultimate reason for the persistence of the pain is in the mind/brain or subconscious. This creates or perpetuates the pain in order to distract attention from emotions that are too threatening for the individual to address consciously, such as anger, rage, grief or anxiety, hence the term ‘distraction pain syndrome’. We further suggest that a well controlled clinical trial, coupled with brain imaging studies, could corroborate or refute the promising results of the retrospective clinical studies we have conducted to date.