Over more than 35 years in practice, I’ve developed expertise in analyzing the mobility of the spine, the status of the intervertebral discs, the suppleness and strength of spinal muscles, and the state of the nervous system as it regulates spinal movement and interprets and responds to pain.

To deepen my body of knowledge, I’ve also become informed about the chemical processes of inflammation, pain signaling, tissue repair, and the hormonal responses to spinal stress.

As extensive as this base of knowledge and experience is, there are still other aspects of life that have an impact on the experience of back pain.

The bio-psycho-social model

Physicians who recognize the multidimensional nature of back pain (and other health issues) have developed the biopsychosocial model to describe the complex web of factors that influence your spinal health.

The “Bio” part of the biopsychosocial model explains back pain based on anatomical factors:

• the biomechanics of the spine,
• the specific muscles, joints, or discs that are under stress,
• the chemical signals of inflammation,
• the nerve pathways that carry pain messages,

and so forth.

But the “Bio” part of biopsychosocial doesn’t give you a complete explanation of back pain. That’s because your feelings and moods (depression, anger, anxiety, etc.), along with the emotional meaning you associate with  pain all play into your back problems. These are the psycho- parts of the biopsychosocial model.

There are strong correlations between social factors and back pain too.  These include…

• Occupational status
• Social class
• Support of spouse/significant other
• Economic status

Because of the complex way all of these bio, psycho and social factors interact, it can become impossible to identify a specific cause of back pain.

Fortunately, if you have back pain, you can tune into your own body and life experience to identify and address the factors that are most important to your situation.