I hear doctors aren't treating low back pain like they used to. I saw a TV special that said most low back pain is caused by psychosocial issues. Just exactly what does that mean anyway? Do I have back pain because I am a social misfit?

Not at all. The new understanding of low back pain looks at the total person -- not just the biology and biomechanics of your spine. Back pain whether from an injury or unknown cause is very real. But the stresses and strains of the body as well as the stress on the mind are both part of the picture.

It's clear now that the broader view of life helps explain why pain becomes chronic lasting more than a few weeks. For example there is the fear of reinjury. This is one very important psychosocial factor in chronic back pain. The person in pain is afraid to move because it will hurt. Or maybe the pain is getting better but the patient is still avoiding certain motions or activities to keep from getting hurt again. This leads to a cycle of pain - no movement - pain.

Sometimes the psychologic or emotional distress of pain leads people to blow it out of proportion. This is called pain catastrophising and is another psychosocial variable.

Doctors realize now it's best to be aware of all aspects of pain. Keep moving and don't let pain rule what you do or don't do. In other words, don't let fear keep you from getting better.