#37 - Back Pain and the Brain: Rethinking Chronic Discomfort

Back pain is one of the most common health problems in the world — but also one of the most mysterious. Scans don’t always match symptoms, treatments don’t always provide relief, and many people feel stuck with ongoing discomfort.

In this episode, I explore chronic, non-specific low back pain through a biopsychosocial lens. Basically, we’re looking beyond just the spine to understand how biology, psychology, and environment all shape the way pain is experienced.

You’ll hear about:

• What makes non-specific low back pain so puzzling
• How pain perception actually works (pain ≠ tissue damage)
• Why the biopsychosocial model is key to understanding pain
• The role of self-regulation in shaping pain responses
• What research says about meditation for back pain
• How to reframe back pain when you feel like you’re hitting a wall
• Journal prompts to reflect on your own experience
  

By the end, you’ll have a new way to think about back pain, one that expands the options for healing beyond the body alone.

• Engel, G. L. (1977). The need for a new medical model: a challenge for biomedicine. Science, 196(4286), 129–136. (Origin of the biopsychosocial model)
• Study on self-regulation and pain: Wager, T. D., et al. (2013). An fMRI-based neurologic signature of physical pain. New England Journal of Medicine, 368(15), 1388–1397. (and related follow-up studies on cognitive self-regulation impacting autonomic markers — you summarised one in your notes)
• Systematic review on meditation and back pain: Cramer, H., et al. (2022). Meditation for adults with non-specific low back pain: a systematic review and meta-analysis. (Included 8 RCTs, ~1,234 participants, moderate-certainty evidence of small benefits for disability and long-term pain