Back pain eased by a little adversity

U. BUFFALO (US)—A little adversity may actually be beneficial and protective to those with chronic back pain, a new study finds.

These individuals experience less physical impairment and spend less time in doctor’s offices or health clinics, says Mark Seery, assistant professor of psychology at the University at Buffalo.

Seery emphasizes that the key to the benefit is the experience of “some” prior adverse events as opposed to many or none at all.

“This study of 396 adults with chronic back pain (CBP) found that those with some lifetime adversity reported less physical impairment, disability, and heavy utilization of health care than those who had experienced either no adversity or a high level of adversity,” Seery says.

“The data suggest that adversity-exposure also may protect against psychiatric disturbances that occur with CBP,” Seery says, “and additional analyses found no alternative explanations of our findings.”

Details will appear in the September issue of the journal Pain.

Study participants had previously acknowledged a history of CBP when reporting physical health status in an online survey. They completed a survey of lifetime exposure to 37 adverse events, including one’s own or a loved one’s illness/injury, sexual and non-sexual violence, bereavement, social or environmental stress, disaster, and various relationship stresses.

Subjects subsequently reported self-rated functional impairment, disabled employment status, frequency of back pain treatment, prescription painkiller use, and whether they currently sought treatment for comorbid psychiatric disorders.

Observed patterns of relationships between adversity and CBP-related outcomes may reflect the possibility that resilience, a phenomenon largely ignored in previous CBP research, is occurring.

“It appears,” says Seery, “that adversity may promote the development of psychological and social resources that help one tolerate adversity, which in this case leads to better CBP-related outcomes.

“It may be that the experience of prior, low-levels of adversity may cause sufferers to reappraise stressful and potentially debilitating symptoms of CBP as minor annoyances that do not substantially interfere with life.”

Previous attempts to understand the persistence, refractoriness, and disability associated with CBP have underscored the importance of psychosocial variables and demonstrated an association between CBP and lifetime exposure to adverse events.

“Previous research suggests that exposure to adverse life events correlates with greater CBP severity,” he says. “This implies that the optimal situation would be one in which individuals have not been exposed to any adverse lifetime events.

“It appears, however, that the relationship between adversity and chronic pain is not so simple, in that experiencing some prior adversity is actually most beneficial.”

Researchers from the University of California, Irvine contributed to the study.

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chat6 Comments

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6 Comments

  1. Dr. O'

    It was my experience that people who had relatives and close friends with adversity also tended to have a greater ability to tolerate pain. In the majority of cases the pain had to be on the lower side of the pain scale. (The famous 0 to 10 scale) I would be interested in knowing what degree of pain the investigators found was the point where the “adversity effect” stopped being effective.

  2. emc2

    I’m wondering what qualifies as ‘some lifetime adversity’ vs. ‘high level of adversity.’ And how can this be used therapeutically? Can a physician tell a patient, “Your back pain would go away if you had had a more rigorous childhood.”

  3. WillWoodsIA

    There are some pretty huge assumptions being drawn here to mathematical correlations I know of no proof of…

    the authors may wish to review this: http://onlinelibrary.wiley.com/doi/10.1111/j.1467-8624.2004.00699.x/abstract

    and hopefully they mapped population frequency in high and low adversity against the effects since one would expect a higher degree of self-selected variation and outlier occurrence across a larger base group to skew the averages systemically, but I am not paying $31 to find out…

  4. Daniel

    @emc2 It’s funny to think about applying these findings to develop new therapies. “Ok, now we’re going to induce some pain, so that you feel less pain”. Not impossible, but pretty counter-intuitive.

    A more likely application may lie in parenting: those who shield their children to much from pain may be doing them a disservice. Of course, we don’t want parents to go overboard and start neglecting their ids. What this seems to suggest is that parents who find themselves in situations where they are in a position to prevent something painful from happening to their child should refrain and think to themselves, “Is this something that my child is capable of dealing with on his or her own?” Such moments could serve as valuable learning experiences from the perspective of being able to deal with pain, which will be unavoidable later in life. I’m guessing that most parents instinctively believe is the right approach, so what I’m saying probably isn’t hugely ground-breaking for them, but it is interesting to see science supporting wisdom of this parenting style.

  5. Daniel

    I hope that didn’t sound like I was putting words into the scientists’ mouths. I’m just saying you could view this as indirectly supporting a particular parenting style.. I was probably going out on a limb there to go from CBP to parenting, but it’s always fun to think about how scientific findings can find application in everyday life.

  6. StevieN235

    I have had chronic back pain due to a herniated disk and degenerative disk disease for about 15 years now. I also have had shoulder pain for about two years due to an injury. My pain is always there, most of the time ignorable, some of the time intolerable. During the intolerable times, I take narcotics: pain killers and muscle relaxers. Not a lot mind you, but the amount I need has slowly increased over the years. Physical therapy, exercise, stretching, a ridiculous number of hot baths, and deep tissue massage also help to alleviate the worst symptoms, but the pain always returns.

    My father, who is in his 70’s and is althetic like he is still in his 30’s, recommend the Dr. Max Power Joint Support with Vitamin B12 – its glucosamine and MSM supplement. I was shocked. In two weeks I was literally pain free, for the first time in years. My back feels better than it has since 1995. The pain is non-existent, and what little there occasionally is resolves with a little stretching. My shoulder, while still clearly injured, has significantly less pain and a vastly increased range of motion. I no longer scream when I pick up the milk jug or my three year old daughter. Overall, I feel better and am in a much sunnier mood.

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