Situation: You tell your friend that your back is killing you, and he tells you it’s all in your head. You insist that you have “somatic” back pain, and he says, “You, mean ‘psychosomatic,’ don’t you?”
While you consider for a moment finding a more sensitive friend, you instead decide to inform this person that, yes, there is such a thing as psychosomatic back pain – often referred to as stress-induced back pain – but what you have is somatic pain, which is a horse of a different color.
The word “somatic” means “of, or relating to, the body.” The somatic nervous system is responsible for all of your voluntary movements – those that require you to think about them before they happen – for example, running or jumping.
Somatic pain is produced by the activation of pain receptors either on the surface of the body or in the musculoskeletal tissues inside the body. When it occurs in the musculoskeletal tissues, it is called deep somatic pain.
Common causes of somatic pain include changes in the bone or pressure on nerves (examples of deep somatic pain) and post-surgical pain from an incision (an example of surface pain). Deep somatic pain is usually described as dull or aching but localized. Surface somatic pain is usually a sharper and more biting kind of pain.
Frequently, the tensions of everyday life – being a slave to your PDA, dealing with kids, bosses, spouse, etc. – can produce muscle fatigue and soreness that can make you susceptible to somatic back pain.
Here’s how it happens: When your muscles are fatigued or sore, any new demands that you put on those muscles, such as pulling the rope starter on your lawn mower, can be enough to trigger a back spasm. This can sometimes lead to disk degeneration and sciatica.
As with other types of back pain, treatment options typically include pain medications, hot packs, ultrasound, electrical stimulation, and physical therapy. Unfortunately, these treatments do not provide long-term relief because they merely address the symptoms and fail to address the cause of your condition.
A more logical alternative is to work toward balancing the body – both emotionally and physically. To do this, it is necessary to eliminate – or at least reduce – the amount of stress in your life (Yeah, right). Believe it or not, this can be done via a variety of techniques, some of which have proven successful over thousands of years (you think building the Great Wall of China was a walk in the park?).
This would include alternative treatments such yoga, relaxation therapy, as well as targeted exercises, the primary goal of which should be to bring the muscles back into proper balance. In many cases, exercise is wrongly focused on the degree of effort (number of reps, frequency of workouts) and strength-building rather than muscle control. Ironically, working too hard or too fast can actually slow your progress.
It may seem counter-intuitive, but you need to learn how to control your muscles in order to relax them. Before you say you already know how to relax your muscles, keep in mind that relaxing your muscles is not the same thing as flopping down on the sofa.
While you may feel comfortable slouching on the sofa (because your back and abdominal muscles are relaxed), you are actually making your breathing shallower and compressing your spine in several places. Instead, you need to use proper exercise techniques that will trigger a relaxation response in the targeted muscles.
Although somatic back pain has a physiological source, it is also true that psychological factors can play a part in learning to live with the discomfort.
For example, a person suffering from chronic pain may shy away from doing certain activities – at work or play – fearing they might make their situation worse. As your activity level decreases, your muscles are going to get weaker. You may also put on weight. And your overall physical condition will decline. This will only reinforce the belief that you must limit your activities even further, which can lead to a downward emotional spiral.
In addition, you may begin to think that no matter what you do, things will never improve or, worse, that you are somehow a burden on your family and others – the kind of mindset that can bring on anxiety and depression.
All of this does not mean that the pain is merely in your head. For most people in this situation the pain is decidedly real, even if it may be hard to find a physical cause.
According to the experts, the best thing you can do to for somatic back pain is to work on toning your muscles so they can maintain the proper alignment of your back. Muscle balances therapy is one such treatment that should be considered.
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Updated: May 12,2011