# Why Our Back Hurts Without an Obvious Cause – Psychosomatics Has the Answer
Back pain is one of the most common health complaints of modern times. It is estimated that up to 80% of people will experience an episode of back pain during their lifetime, with a large proportion of them finding no clear physical cause during medical examination. The X-ray is fine, the MRI shows nothing, the orthopaedist shrugs – and yet the pain persists. What is happening in such a case? The answer may lie not in the spine, but deep within the mind.
Psychosomatics – the science studying the relationship between psychological state and physical health – offers a fascinating explanation for pain that seems mysterious or inexplicable. This is not esoteric speculation. The World Health Organisation and a number of renowned research institutions now recognise that body and mind form an inseparable whole, whose balance is directly reflected in physical health. Yet many people still refuse to accept the idea that their back pain might be caused by stress, unresolved emotions, or long-term tension in their lives.
Try our natural products
The Body as a Mirror of the Soul
The back is not merely a mechanical structure of bones, muscles, and ligaments. From a psychosomatic perspective, it represents the symbolic centre of load-bearing – both literally and figuratively, we carry the burdens of everyday life on our backs. It is therefore no coincidence that pain in the lumbar spine is most commonly associated with feelings of existential uncertainty, financial pressure, or being overwhelmed by work responsibilities. The thoracic spine, in turn, tends to be the place where emotional injury accumulates – grief, loss, suppressed longing. The cervical spine often responds to information overload, the need for control, or the inability to say "no."
American physician and professor John Sarno, who worked at the New York University School of Medicine, spent decades researching unexplained back pain. He developed the theory of Tension Myositis Syndrome (TMS), according to which the brain deliberately induces physical pain as a way of diverting attention from painful emotions. Although his theory remains controversial in parts of the medical community, thousands of patients worldwide confirm that understanding the psychosomatic nature of their condition led to relief where traditional treatment had failed. His book Healing Back Pain became an international bestseller and opened a discussion that continues to resonate in medicine today.
A practical example? Consider Martina, a forty-four-year-old accountant from Prague. She suffered from chronic lower back pain for years. She underwent physiotherapy, chiropractic treatment, and massage, and received injections. Nothing helped for more than a few days. It was only when she began working with a psychotherapist and gradually came to realise how long she had been suppressing her anger towards her supervisor and how afraid she was of losing her job, that the pain began to subside. Today she says she feels better than she did at twenty-five – and her back stopped hurting the moment she stopped staying silent.
Martina's story is not unique. Research repeatedly shows that chronic back pain without structural findings is closely associated with psychological factors such as anxiety, depression, job dissatisfaction, or traumatic experiences from the past. A study published in the journal Spine demonstrated that psychological distress is a stronger predictor of the transition from acute to chronic back pain than the physical findings on imaging methods themselves.
How Stress Literally Hurts
To understand how psychosomatics works at the biological level, it is necessary to grasp the basic mechanism. When the brain evaluates a situation as threatening – whether it is genuine physical danger or chronic work-related stress – it triggers a stress response. The adrenal glands release cortisol and adrenaline, muscles tense up, and breathing becomes shallower. The body prepares for flight or fight. Yet in the modern world, we mostly neither flee nor fight – we simply sit at our computers and suppress the stress within ourselves. Tension that has no physical outlet becomes stored in muscles, fascia, and connective tissues. And the result is pain.
Chronic stress also changes the way the nervous system processes pain signals. So-called central sensitisation occurs – a state in which the nervous system becomes so hypersensitive that it responds with pain even to stimuli that would under normal circumstances be completely painless. This phenomenon explains why people suffering from chronic back pain sometimes describe pain even at the slightest touch or with minimal physical exertion. Their spine is anatomically fine, but their nervous system has learned to be in pain.
As leading British neuroscientist and science communicator Professor Lorimer Moseley puts it: "Pain is always real – but it is not always an accurate reflection of tissue damage." This statement holds enormous potential for understanding one's own body. The pain we feel is real and should not be dismissed. At the same time, however, it does not necessarily mean that something is physically broken. It may be a signal that the brain and body need a different form of care.
Sleep also plays an important role. A lack of quality sleep lowers the pain threshold and impairs the body's ability to regenerate. People who chronically sleep fewer than seven hours show significantly higher sensitivity to pain – and the back is one of the first areas where this manifests. Yet sleep itself is strongly influenced by psychological state: anxiety and rumination at night are among the most common causes of insomnia. This creates a vicious cycle from which it is not easy to escape without a comprehensive approach.
There are, however, a number of things that can help break this cycle and support both body and mind simultaneously. Movement – not pushing through pain, but conscious, gentle movement such as yoga, tai chi, or swimming – demonstrably reduces levels of stress hormones while also strengthening the deep stabilising muscles of the spine. Regular meditation and mindfulness techniques change the structure of the brain in ways that reduce the perception of pain – this is confirmed by brain imaging studies conducted at the prestigious Harvard Medical School. Psychotherapy, particularly cognitive-behavioural therapy focused on pain, is now among the recommended approaches for treating chronic pain in a number of European countries.
The environment in which we live and work also has a significant impact. Ergonomics does play a role – a poorly adjusted chair or desk can place mechanical strain on the back – but research shows that job satisfaction and interpersonal relationships in the workplace have a greater influence on back pain than the physical conditions themselves. A person sitting at a perfectly ergonomic desk who hates their job is more likely to experience back pain than someone sitting on a less perfect chair who looks forward to going to work.
The family and relationship environment functions similarly. Long-term tension in relationships, feelings of being misunderstood, unspoken conflicts, or emotional estrangement – all of these are factors that can manifest as physical pain. The body remembers what the mind refuses to process. And the back is one of the most sensitive areas where this body-stored memory expresses itself.
What to Do? A Path to Relief
If your back hurts and doctors cannot find any physical cause, this is paradoxically good news – it means the spine is not damaged and that the cause can be addressed differently. The first step is accepting the idea that psychosomatic pain is just as real as pain caused by a fracture; it simply requires a different approach. It is not about "pulling yourself together" or "stopping complaining" – it is about a deeper understanding of what the body is signalling.
A very useful tool can be keeping a pain journal – recording not only the intensity of the pain, but also the mood, events, and emotions of each day. People who try this practice often discover surprising patterns for themselves: the pain worsens before important meetings, after conflicts with loved ones, or during periods of increased workload. This awareness itself has healing potential.
A further step may be seeking professional help – not necessarily from yet another orthopaedist, but from a psychotherapist experienced in psychosomatic complaints. In the Czech Republic, the number of specialists working at the interface of psychology and physical health is growing. Psychosomatic medicine is becoming a recognised part of healthcare, even within conventional medicine. Further information on how the psyche influences the body is offered by, for example, the Czech Psychosomatic Society, which brings together doctors and therapists working in this field.
Alongside therapy, lifestyle plays a major role. Quality sleep, regular movement, a natural diet, and limiting stimulants such as caffeine and alcohol form the foundation without which other interventions are less effective. Natural products that support relaxation of the nervous system – such as magnesium, which occurs naturally in leafy greens or nuts, or quality dietary supplements – can be a useful part of overall self-care. The important thing is to perceive the body as a whole and not to search for a single "magic" cause or a single "magic" solution.
Back pain without an obvious physical cause is not weakness or imagination. It is the body speaking in a language we have not yet learned to listen to. And learning to read it may be one of the most valuable steps on the path to true health – the kind that encompasses body and mind as one inseparable whole.
