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Lumbago: a psychosomatic symptom?

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How many times do we refer to the spine in our language:

  • obtorto collo = unwillingly;
  • with a straight back= being in one piece;
  • kidney stroke= intense effort to overcome an obstacle;
  • spineless= lacking in character, personality and energy (including moral energy).

These are all sayings that, by metaphorically using the back, express characteristics of the person both from the point of view of temperament and in reference to his or her modes of reaction or even moral qualities.
After all, the spine is the structure that holds up our body, provides it with solidity and elasticity, stability and movement.
From the point of view of evolution, it has undergone the greatest changes in the transition to the upright position. That is, it is a structure that is extremely sensitive to both internal and external stresses and at the same time adaptable.

This is to emphasize how disorders involving the neck, shoulders and lower back can be not only the result of mechanical problems but also the sign of psychological distress related to difficulties in integrating and adapting with the world around us.
That is, the result of a benign and reversible process in the musculature that is psychosomatic in nature and has been called “tension myositis.”
John Sarno, MD, a physician and professor of physical medicine and rehabilitation at New York University expanded the concept by talking about “tension myositis syndrome,” relating back pain to stress, especially to a condition of chronic stress.

Talking about psychological factors that are at the origin of back pain or that contribute to its maintenance does not mean that the symptoms are imaginary: they are very real physical problems caused by psychological discomforts and that can only “melt away” (even from the physical point of view of pain) if one can identify what discomfort they are a sign of and what behavioral, emotional, existential, relational corrections they need .
Refuting a popularized, compartmentalized, mechanistic psychosomatic view, whereby hunched shoulders= depression; lumbar stiffness= unsatisfactory sexual intercourse; pelvic locking= overcontrol,etc. etc.

While recognizing the evocative power of these images, we emphasize that the symptom should be considered not only as a nuisance to be eliminated but as a thread that can lead us into the patient’s life.

In fact, it provides us with a number of important pieces of information; it tells us what the subject is like, what his aspirations and weaknesses are, what stage of life he is going through, how he is coping with difficulties, etc.

Only then is it possible to hypothesize a specific and personalized therapeutic intervention, made with the active participation of the patient. This process is certainly less immediate and longer than heavy use of anti-inflammatories, but unlike the latter, there are no negative side effects.

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