How come people with back conditions are more likely to have back pain?

This is one questions I;m still pondering. When I was younger I had a condition called Spondylolysis which is the precursor to Spondylolisthesis. Apparently 50% of all youth back pain is attrituable to spondylolysis. Meaning that 50% of all kids who report with back pain have spondylolysis but only 10% of adolescents have the condition. If back pain is attrituable to emotions then how come having conditions such as spondylolysis, spondylolisthesis and herniated discs make you statistically more likely to have back pain.

I realize the counter argument is that only 25% of kids with spondylolysis are symptomatic.

 

Very simple explanation: those spinal abnormalities are absolutely normal and their presence has nothing to do with the pain.

Considering the tremendous pressure and tension adolescents go through these days, we have to wonder why the percentage of those with back pain is not higher!

 

The labels and medicalization causes the nocebo effect. Once the idea is planted in a person (and their parents/ family) they are more likely to view themselves as "broken" or "damaged" in some way, making them far more susceptible and suggestible to developing chronic pain later in life. If family members are anxious and constantly giving messages of danger ("careful! don't hurt yourself!" etc etc), the child is more likely to grow up feeling unsafe in their own body. Howard Stern suffered from severe back pain and he described his mom as raising him like "a veal in a box". Conversely, if children are not given these messages, they tend to bounce back quickly and unscathed becasue they live very much in the moment. Children do not tend to catastrophize and since their life experience is short they ae not burdened by expectations of bad things happening. It doesn't occur to them at all that they would develop chronic pain or not get better. I hope I understood your question, and answered it somewhat.

 

I second what @miffybunny says about the nocebo effect, and just a week ago had a perfect example of it: I have an issue with my lower back/pelvis: I have had a weird "clicking" feeling and feeling of something moving/instability for a year or more, but only in the last 6 months has it hurt (after I started seeing doctors about it and obsessively researching it). About 2 weeks ago my wife and I were talking about it and she pointed out that one of her knees has a "clicking" sound and feeling that the other knee doesn't and has been like that for years (she never even mentioned it before) but she has never worried about it and it has never hurt. She demonstrated it to me. Then she said that FOR THE NEXT 5 DAYS AFTER SHE SHOWED IT TO ME, it hurt, even though it had never hurt prior to that (but now is ok; she is not a worrier like me). But the point being, that it was only after she introduced the idea in her own mind that there was "something wrong", that it start to hurt.

So it wouldn't surprise me that if a doc tells a kid he has the scary-sounding thing called Spondylosis, that x% of them will develop pain simply by being told that.

 

I would reverse this;

spondylolisthesis and herniated discs make you statistically more likely to have back pain.

do those conditions make you statically more likely? It depends which way you view the statistics. Many studies have shown no correlation. Statistically more likely based on what? If you took 100 people with no back pain, you would find ‘abnormalities’. So then you could say ‘statistically you’re LESS likely to have pain if you have an abnormality, because my study group are all pain free but have bulging discs. Yet my other study group are all in pain and their scans are not as ‘abnormal’ as my pain free group. And each one of those would be a truthful as one another; which, in ALOT of cases, blows the correlation completely out of the water.

so people may say ‘well why are so many people presenting with back pain and having these abnormalities?’ ....it’s nothing to do with the ‘condition’. It’s a very nice coincidence of placement.

If you search for something enough you will find it. Whatever it, may be.

 

This question came up when Sarno was still alive.

If our body and mind are a 100% integrated unit with no boundaries between them and our emotional/mental is needing a distraction for a balance, it's going to hunt down something in my body that is believable...something 'less than ideal'... Before I got diagnosed with all of my back problems, I had all sorts of other issues...just no 'anomaly' to blame them on, so they didn't make the cut list as longterm distractions. In fact my back pain was only medium UNTIL THEY TOLD ME I had the laundry list of 'anomalies'...my pain spiked significantly then.

That is why the mind/body hunts down something you will believe.