What is it about?

Low back pain is often associated with psychological states such as anxiety, fear or low mood. This is thought to result from the negative impact of living with back pain. This systematic review suggests that emotional distress could precede low back pain, and that mood disorders could potentiate low back pain in a bidirectional relationship.

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Why is it important?

Low back pain is the leading cause of years living with a disability with a worldwide prevalence of 577 million people. There is no patho-anatomical origin for low back pain in 85 -90% of cases. This study highlights the need to view mental wellbeing as an important contributor to acute low back pain presentations, and should be explored early in management strategies.


Having worked clinically as a Physiotherapist for over twenty years it is clear that back pain is a complex presentation. The emotional strain of living with chronic back pain is understandable as people disengage with activities and try to live with pain on a daily business. I always wondered if the mental distress could precede the low back pain and this review strongly suggests that this is the case. I hope it makes conversations easier around the potential triggers of acute low back pain.

Shane Collins
University of Ulster

Read the Original

This page is a summary of: Can emotional distress induce acute low back pain? A systematic review, Physiotherapy Practice and Research, December 2023, IOS Press,
DOI: 10.3233/ppr-230737.
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