Why Do We Have Back Pain? The Perception Of Pain

Perception of Pain

Human beings universally share Low Back Pain (LBP) and the perception of pain as the sensation of back pain. Back pain, a ubiquitous companion in the human condition, transcends its physical manifestation to become a complex interplay of sensory experiences and cognitive interpretations. But why does it happen? Some say from lifting heavy loads, some say from injuries. However, the actual cause might differ from person to person, but how we perceive pain also rules the intensity with which we feel it.


Trying to understand the causal beliefs of pain and its impact on how we consider our LBP, the common-sense model, a framework comprising identity, causation, consequences, control, and timelines, comes into consideration—each a pivotal element in constructing our pain perception. This narrative extends beyond the physiological, exploring the psychological dimensions influencing how we respond to and manage LBP.

The Physiology Of Back Pain

It is important for people to understand the physiology of back pain. This understanding helps to grasp the complexities that contribute to this prevalent ailment. Back pain can stem from various physiological factors, and a closer examination of its underlying mechanisms provides valuable insights for prevention and effective management.


Back pain often originates from strained muscles, ligaments, or tendons. Poor posture, improper lifting techniques, and sudden movements can strain these structures, leading to discomfort. Additionally, conditions like herniated discs, spinal stenosis, and osteoarthritis can contribute to the physiological origins of back pain. While imbalances in muscle strength and flexibility can create undue stress on the spine, contributing to pain, at the same time, anatomical variations or irregularities in the spine’s structure may predispose individuals to back pain.


This also results in conditions such as sciatica, which involves compression of the sciatic nerve and causes radiating pain down the leg. Understanding the physical components of back pain lays the foundation for effective prevention and targeted interventions.

The Mind-Body Connection

The mind-body connection underscores the profound impact of cognitive and emotional factors on back pain perception and experience. Let’s break this interplay, which is essential for a holistic approach to back pain management.

Cognitive Interpretations For The Perception Of Pain

Our cognitive interpretations significantly influence how we perceive and respond to back pain. Beliefs and expectations about pain, rooted in personal experiences and cultural influences, shape the subjective experience of discomfort. For example, someone who views back pain as a sign of structural damage may respond differently than someone who links it to temporary muscle strain. These beliefs can impact pain intensity, the perceived threat of the pain, and the chosen coping mechanisms.


Furthermore, attention and focus are important in shaping the pain experience. Concentrating on pain signals, whether consciously or unconsciously, can magnify the perceived intensity of discomfort; mindfulness and techniques that redirect attention away from pain, such as relaxation exercises, can be valuable tools in managing back pain by altering cognitive interpretations and redirecting focus.

Psychological Factors Influencing The Perception Of Pain

Stress and emotional well-being are integral components of the mind-body connection in the context of back pain. Emotional stress can manifest physically, leading to muscle tension and deepening discomfort. Chronic stress may contribute to the endurance or worsening of back pain. Plus, psychosocial factors, including work-related stress, strained relationships, or a lack of social support, can contribute to the overall pain experience.


Recognizing these psychological factors enables a more comprehensive approach to back pain management. Strategies such as stress reduction techniques, counseling, and fostering a supportive social environment become essential elements in addressing not only the physical symptoms but also the psychological aspects of back pain. By acknowledging and addressing the psychological dimensions, individuals can embark on a more holistic journey toward effective pain management and improved overall well-being.


In the past, researchers have focused more on the “structural injury or impairment,” ignoring other categories of causal beliefs. However, it shows that there was bias depending on what most believed. These findings reflect a concentrated effort to understand how individuals conceptualize the physical origins of their back pain. This also shows that more research is required to understand the perception of pain and its impact.

The Causal Beliefs and the Perception of Pain

Causal beliefs are the cognitive constructs individuals develop to understand the origins of back pain, shaping the narrative surrounding their discomfort. These beliefs span diverse categories, encompassing aspects such as “structural injury or impairment,” “lifting and bending,” and “mental or psychological” influences.


Research indicates that these beliefs extend beyond intellectual understanding1, profoundly impacting behavior. For example, beliefs in structural damage may lead to cautious, overprotective behaviors, influencing daily activities. Such beliefs can also act as barriers to guideline-based care, affecting the alignment of patient perspectives with evidence-based interventions.

Dynamic Disc Designs Models Help Reduce Fears While Educating

Communicating diagnostic labels in a clinical setting can be a critical step in the trajectory of a patient’s low back pain. At Dynamic Disc Designs, we have created realistic spine models to help spine professionals relay the important anatomical points, without a fear inducing model, to empower and set the stage for care. Explore how ddd can change the delivery and ultimately, the outcome.

“These models have transformed my patient education. They bring the MRI to life. ddd models are a massive piece in the patient education picture. These models are now an integral part of my practice.”
Andrew Wilson PT Director and Chartered Physiotherapist, United Kingdom
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