The crash of conflicting beliefs juggling in your head could leave you with more than just an aching brain. It could cause physical pain in the neck and back, according to a new study that asked volunteers to lift light boxes while being told they were doing unsatisfying work.
The team of researchers from Ohio State University and the University of Michigan in the US collected critical feedback from volunteers after they were told they were doing the lifting task well. The resulting psychological discomfort added extra pressure to the participants’ necks and lower backs, the researchers found.
While only small, the study could have implications for workplace safety that should recognize how psychosocial stressors, and cognitive dissonance in particular, can damage physical health.
“Fundamentally, the study scratched the surface by showing there’s something to this,” explains William Marras, a biomechanics researcher at Ohio State University.
Researchers like Marras have realized that pain involves a complex interaction between body and mind. But it took decades for the “biopsychosocial” model of pain to really catch on after it was first described in the 1980s.
Pain is a heady mix of physical, social and psychological stressors, meaning it can occur due to physical exertion coupled with financial stress and poor mental health. Even the words a doctor uses to describe low back pain can shape someone’s expectations of recovery.
“To achieve the goal of treating patients rather than spines, we must address low back disability as a disease rather than low back pain as a purely physical disease,” wrote orthopedic surgeon Gordon Waddell in 1987.
Most research to date, however, has revolved around the coexistence of chronic pain with depression, anxiety, and catastrophe tendencies (thinking the worst will happen or things won’t change). Marras and colleagues wanted to understand whether another psychological factor, cognitive dissonance, also affects back and spinal pain.
Think of cognitive dissonance as the psychological whiplash that arises when you try to reconcile multiple, seemingly incompatible beliefs. Difficulty can cause distress that drives us to seek some sort of mental relief.
Marras and colleagues designed a series of experiments to see if this psychological distress manifests itself physically, similar to how depression and anxiety can exacerbate pain.
“To get to that mind-body connection, we set out to look at how people think and, with cognitive dissonance, when people are disturbed by their thoughts,” Marras explains.
In the lab study, 17 volunteers were instructed to move a light box to precise locations while wearing motion sensors to measure how much load they were placing on their spine and back.
During rehearsals, they were told they were moving in the right way to protect their backs. But then the feedback became more and more negative, as participants were told they were doing the task unsatisfactorily.
By comparing the participants’ discomfort scores with the mechanical loads on people’s spines, the researchers found that spinal load peaks increased between 10 and 20 percent when people felt distressed by negative feedback compared to when they felt capable. at the beginning of the task.
“This increase in spine loading occurred in only one condition with a fairly light load,” explains Marras. “You can imagine what it would be like with more complex tasks or higher loads.”
In other words, repeated psychosocial stressors may put more strain on the spine, causing pain, although that remains to be tested.
The loads on the lower back also increased, but only slightly. The distress scores were a combination of physiological measures of stress, including changes in heart rate and blood pressure, and surveys of how participants felt: inspired and strong, or ashamed and distressed.
For those who can move uninhibited, remember that back pain is more than an annoyance; it is the leading cause of years lived with disability worldwide.
A recent analysis of three decades of data found that in 2020 nearly 620 million people worldwide suffered from low back pain affecting their ability to work, move, travel or care for themselves or others. Expected to rise to over 800 million people by 2050, the growing number of back pain sufferers makes it clear that conventional treatments, especially addictive opioid drugs, are not working.
Pain research is moving at a rapid pace to understand how chronic pain begins, understand why it persists, and find effective ways to relieve it.
Understanding the psychosocial dimensions of pain appears to be of great help, with studies finding that adding psychological therapy to physical treatments could be the key to overcoming chronic back pain. Indeed, trials of more holistic models of care, including group therapy, have reduced opioid use without making pain worse.
This latest study adds another dimension to that growing body of research. Only by understanding what increases people’s pain can we hope to ease it.
The study was published in Ergonomics.
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