Four things people living with chronic back pain want you to know


Chronic back pain is complicated, especially when nociplastic pain is present. This pain type amplifies the pain level; it arises from abnormal sensory processing in the brain. Nociplatic pain distorts mild back discomfort into excruciating pain. This cruel, confused pain signal lurks beneath many chronic pain conditions.


1. The pain does exist; it is not all in their heads

Nociplastic pain is debilitating but it does not show on standard medical tests. Someone with severe back pain from this pain type may have only mild findings on imaging and a normal exam. Physical disability with mostly normal tests results in the assumption the person is faking or exaggerating their limitations. The pain does come from their head but only because their brain, which processes the pain, is located there.


2. Most people are not seeking drugs, they are seeking relief

People with chronic back pain are often mistreated and misunderstood. When their back hurts, it is hard to get through the day. The misery makes them desperate for relief. Given their distress level, they ask for opioid pain medications but don’t mistake their motivation. The majority are seeking relief, a reprieve from their pain prison. They are not asking for drugs to get high. Most are open to trying anything that may help.


3. Their limitations come from more than just back pain

Back pain from nociplastic pain doesn’t just affect the back, it affects the whole body. It also causes fatigue, poor sleep, and thinking difficulties. They have less energy per day because of fatigue. Then, poor sleep worsens the pain and fatigue. Plus thinking difficulties, like brain fog, slow and muddle their cognition. When you add up all the symptoms, it is no wonder they struggle to function.


4. They often suffer for years before the correct diagnosis is made

Imagine not being believed or helped for years before the correct source of your medical issue is identified. With a shortage of pain specialists, it can take years to find a medical provider who understands their pain, listens to them, and believes them.


During these years, their entire life falls apart. They lose their jobs, struggle to pay for housing, care for their kids, and may even lose their relationships. All while seeing provider after provider who gives them a side-eye because they don’t see anything wrong with the medical tests. As well as wracking up thousands of dollars in medical bills for procedures that didn’t help.


Unfortunately, by the time nociplastic pain is identified, many have given up, defeated by years of misery and lack of help. These are the common features in the journey of a person struggling with chronic low back pain.

I discuss chronic back pain in-depth in Sunbreak: Healing the Pain No One Can Explain.