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Northwestern Medicine Orthopaedics
27650 Ferry Road
Suite 100
Warrenville, IL 60555
Ph: 630.225.2663






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My sister is such a whiner and complainer about her back pain. At our house, we say she is a "whine bagger". Sometimes I can't help but think what she says about her condition (all negative) determines how she is (unable to sit for more than 10 minutes or go to work).Do you think this is just a personality trait and doesn't really affect her pain level? Or does all this complaining really hold her back from getting better?

These are all very good questions and certainly ones that many family and friends have asked about others who suffer from chronic pain. Social scientists work just as hard as biologic scientists trying to understand the mind and behavior of chronic pain sufferers. Some people seem to give in to their back pain while others push through and do whatever they want regardless of the pain. What makes the difference in these two groups of patients? What makes the persistent group keep on keepin' on? Why does the avoidance group give up? One way to better understand the difference in behavior among chronic low back pain sufferers is to look at self-discrepancies. These are the differences between how the patient sees him or herself versus how he or she would like to be. Other measurable self-discrepancies include who you would like to be versus who you think other people want you to be. There is also the difference between who you are and who you are afraid to be. Differences between these conflicting viewpoints can create anxiety, fear, depression, distress, and more pain. Your sister may be experiencing some of this self-discrepancy. Understanding that these conflicts exist, measuring them, and reducing them may help improve function and eliminate disability among chronic back pain sufferers. In fact, researchers in The Netherlands have been working on creating a model to identify and measure self-discrepancies based on behavior. Now they are using this tool to evaluate level of perceived disability and quality of life. They hope to be able to uncover the thought process behind avoidance versus persistence actions. Finding better ways to treat chronic low back pain may depend upon recognizing these behavioral variables.

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