Back Pain All in My Head?

mjcgmmjcg Posts: 72
edited 01/06/2020 - 7:06 PM in Lower Back Pain Forum

My physical therapist asked me how I said my lower back was still very painful.   She seemed surprised and wanted to know if I'd been doing the assigned exercises (I have!).   She went on to tell me that because I have no injury and that our boides are good healing machines that the pain I'm experiencing is probably just my brain giving me false signals.  Um, what??  I'm not sure what to do now.  I understand PT helps strengthen the muscles and ligaments that support our spine, but my back still hurts!  How can my brain be making this up?  Has anyone ever told you it's all in your head?   I'm scheduled for a radio frequency ablation in two days, so I know my spine specialist doesn't think I'm making it up (and the MRI doesn't seem to support that it's all in my head either). 



  • Wow, all on your head??? Best thing I did after back surgery was fire my PT and seek out someone who cared. Not saying you should but maybe if I’d have hooked up with my current PT before I had surgery i’d have had an easier surgery or less painful recovery.  Maybe...

  • @mjcg I would find another PT because I've been to a bunch of different PT's over the last decade and I've never had any of them tell me that.  It seems lazy and an admission of their lack of ideas or willingness to help you further.  Just my opinion, but if my PT said that to me I would probably have been asked to leave due to an argument.  Good luck!

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  • JoelQ and Richardson - Thank you so much for responding.  I was worried no one would comment.  I was truly shocked when she started to suggest the pain was not real, that somehow my brain was giving me "fake" signals.  I agree with your recommendations that I stop seeing her.  I should have spoken up during the moment, but I just couldn't believe what I was hearing!   I can do the exercises on my own, stick with my spine specialist and hope someday this pain will stop.   

  • @mjcg don't give up that's fur sure.  Shouldn't have to live with pain.  Good luck.  I understand what you're going through for sure.  Its been over a year now that I have been searching for answers and sometimes I feel as though I must be going crazy after all the results come back and they tell me that there isn't anything significant.  it sure feels significant. 

  • G’day mjcg, I attended a hospital run  pain clinic. They are the ones that told the group I was in that the pain was in or heads. I told them it’s only in my head when my neck causes my migraines.  I was so angry , I asked them why do I limp? Why can’t I hold my head straight or why do I have to drink from a travel mug .  I know my pain is in my spine and the nerve, muscles ect it puts out. A few years later I requested to see a private run pain specialist to help me taper off all the meds I was on to start from scratch. He was wonderful. I actually cried when he told me my pain was not in my head. I knew it wasn’t but it gets pumped into You in those pain clinics that it does do ya head in. Harpy

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  • mjcg - I was told by many specialists over 17 years that my pain was "made up" and all in my head.  In my case, those specialists were not listening to me about my neck trauma years earlier and missed diagnosing me.  Now I have permanent spine injury because I did nt receive timely surgical intervention. 

    As recommended earlier in this thread, you likely want to move on from that physical therapist.  Yes, there are studies that identify that long term chronic pain does some "rewiring of the brain", but when our bodies are screaming from pain, there is most likely a reason.

  • I've been in pain for 25 years and have heard this, also had spine fusion surgery C4-C7. Even after spine surgery I've heard this. I think some people are actually saying it's all in your head and some sound like they are saying that but are really referring to the fact that some nerves may continue to send pain signals long after the offending episode happened. In effect, it's not that you're imagining it but that the nerves continue to send the pain signals when they can't see any cause or reason why it would continue to hurt after a certain period of time.

    It's insulting to hear this and really doesn't do anything to help healing. I think the PT's say it when they don't know what else to do. I get the feeling they want to note improvement in your chart to discharge you or it means they didn't do their job.

    A doctor also said MRI's and CAT scans don't always show everything and prove peoples pain. I think people are wired to feel pain differently. Some feel pain easily, doesn't mean they are weak, I think you can have a strong threshold for pain and still be sensitive to feeling pain. Some people have horrible things happen to them and feel little to no pain, doesn't make them tougher.

  • Again, I am so GRATEFUL for those of you who have taken the time to post advice and guidance.  You can't even begin to understand how much this means to me.  I feel so alone at times and this forum has been a saving grace.   

    Richardson - Yes!  I sometimes feel as though I'm going crazy.  And the pain sometimes is so terrible I just want to kneel down and cry.  And I realize I'm not as bad off as so many other people.  I'm ashamed that I can't seem to "handle" this.  Being told it might be all in my head was devastating.

    Harpy - I love the greeting of "G'day"... I wish we did that here in the States.  I'm fortunate in the fact that I've tried very, very hard to only take pain relievers infrequently.  I worry about liver damage (not to mention becoming too dependent on drugs).  But the pain is wrenching and sometimes I'd take anything to find relief.  I'm glad you found someone who cared - that makes all the difference in recovery I'm sure.

    Stiffneck - I'm going to see the PT one more time and then cut ties with her.  I think she's given me enough exercises to continue on my own with.  Not to mention that this site provides good videos I could follow as well.  

    Faith - Maybe what my PT was trying to tell me is similar to what you state.  I know for a fact that when I'm in a stressful situation, the pain is worse.  And I know that our brains do all sorts of things that we don't completely understand.  We can "rewire" ourselves.  Afterall it's a muscle that needs exercise (like learning a new language, or doing puzzles, etc.).  But you are correct, she came across as saying it was all in my head.  I stopped listening to her at that moment.  She clearly was disappointed when I told her that I was still in pain and likely, as you say, wanted to show on her chart that her skills were helping me to improve.  I do wish I was tougher - I feel like my pain tolerance is low.  It's just so frustrating at times.  

    This morning I had a radio frequency ablation done, so I'm keeping my fingers crossed that there will be some relief.  I doubt my spine specialist would have done this procedure if he thought the pain was in my head! 

    Bless you all!!

  • G’day mjcg, I hope all went with your RFA and you get lots of relief from the procedure.               Fair dinkum ,  if the pain was in your head you wouldn’t have been offered that procedure.             I wish my pain was just in my head , seems to be an easier fix that way. I could play with my grandson without out the flare ups afterwards, it’s a bugger.                                                                    I had a huge chunk taken off my cheek on 20th dec, and two other biopsies , skin cancer Is the pits, it’s bloody horrible. I get a melanoma removed from the back of my shoulder tomorrow arvo and on the 24th they go back in and take another chunk out my cheek as they didn’t get it all. I am dreading it, not that I am vain about my look  at all , the scars don’t bother me , it’s just the thought of the weeks pain afterwards. Ouch, I try walking, i tell myself it’s good for me, I push myself to get my steps in every day, the pain is there either way.                                                       It took 7 months to wean off my meds and start back on low doses. There are days I too have extra meds to get through the flare ups.  And I will say it again , I will never let myself get to that state again. Hooroo, harpy

  • mjcg, I agree with everything that has been said and I think Faith had a good point too. . Perhaps she didn't mean that your pain is not real but in a sense all pain emanates from the brain and how it interprets pain. My PT has helped me understand this and she did not mean my pain was not real! If you want, Google the Neuroscience of pain, it's fascinating how our bodies work but the pain is real! I've read several books on the of subject and it sure didn't take away my pain but helped me understand. I took a class on stress management and how it affects chronic pain and learned some things I can do to relieve stress. Pain causes stress and stress increases our pain which causes more pain. Vicious cycle. One of the first things they had us do it gain information on how our brains are actually where our pain comes from. 

    You were so brave to have the ablation. Thus far I've been chicken to try I'd sure  be interested to hear how the procedure went for you and how it has worked as I'm sure everyone here would. I pray it works really well!! 


  • Joanne - Both you and Faith have helped me understand better what my PT was likely (hopefully) trying to tell me.  I will google the Neuroscience of Pain for sure, thanks for the suggestion.  The radio frequency ablation went well.  I was in and out within a hour time.  Yesterday and today I have no pain in my lower back!  My leg still feels tingling and numb at times, but as walked around today I couldn't believe that the stabbing knife pain seems gone.  I'm trying not to get my hopes up but at the same time - have I finally found some relief?  I know it won't last forever and that I need to continue PT to strengthen the muscles and ligaments supporting my spine.  But two days of relief - wow!  

    Harpy - G'day!!  I'm so sorry you're dealing with skin cancer on top of dealing with back pain.  My heart goes out to you and I'm ashamed that I complain so much about my pitiful back issues.  I'm sending positive, healing thoughts your way and hoping all goes well with your surgeries.  Thank you again for your kindness!

  • mjcg, I'm so very glad to hear that you already have relief from the ablation!!! I sure do know what you mean about getting your hopes up, so many times when I have even a tiny bit of relief, I tell myself not to hang on to it too tightly but that's next to impossible so I just try to enjoy it for as long as it might last. Please keep us posted, I've read of so many who have had horrible pain after the procedure for a couple of weeks that it always scares me away from doing it. You are brave! I'm getting to the point where I'm desperate (again) because my leg is so painful I can barely walk no less drive, ugh! I just had a 3rd epidural injection that doesn't seem to be working. Number 2worked for one wonderful and but hardly enough time to strengthen anything. Anyway enjoy every moment!! 

    My heart also goes out to you harpy! I don't know why some have to have SO much pain but you have support and people who care here. Please keep in touch! 

  • I was against getting my nerves done in my neck but definitely will be holding off for as long as I can. After have 8 injections in my lumbar spine I swore off all medical interactions till I totally couldn’t cope mentally. I personally think for me it’s what made me worse, no pain so I continued full time work and do the normal things for me , which are very physical and heavy, I recon it made my spine deteriorate much quicker. 

    Thanks guys, means a lot. My skin doc said she took extra margins out, so the wound is almost 3in long. She said it will leave a hole where it was removed, I said it will Match my shark bite lol ( that’s what I call the huge chunk they took out of my left calf muscle for melanoma back in 04)   The pain from where she cut this melanoma out  Is mostly controlled with my daily meds,  but if I am late on taking me pills, crikey, it hurts. I get the stitches out in two weeks When she re-cuts my face and the results to see what level the melanoma it’s at, a shave biopsy shouldn’t be done as they DONT know the depth as it leaves the cancer behind. Less pain to you, hooroo harpy

  • It's been 9 days since I had the radio frequency ablation done.  I did not find the procedure any more difficult then the spinal injections.  Of course, they gave me a tad bit of twilight drugs so maybe that is why.  I can definitely tell that there is some relief in back pain.  I'm able to walk without being in pain and that is a huge plus for me. My leg still tends to hurt and feel numb, but my spine surgeon had told me that he couldn't help with the leg pain.  I still have pain when I go to bed at night.  I just can't seem to find a comfortable position.  I will continue to keep you posted.  I'd say I'm experiencing a 60% improvement - but it's still early.  My spinal injections always wore off quickly.  Sigh.

    Harpy - I continue to send positive healing thoughts your way.  I can't even begin to imagine what you're going through.  Keep us posted too!

  • G’day mjcg, when I had my injections into the L5/s1 the first 7 worked immediately, though the relief got Less  and less. But the 8 th one was sheer hell . I swore off any injections after that.  thanks for your thoughts, sure is hard enough dealing with my everyday pain and now melanoma again. I tell myself I will be right but deep down I am regretting this coming Friday,  top it off with my mid thoracic Has locked up where it hasn’t before . I Went to a walk in clinic today.  ( my medical centre has Saturday as an open booking day, just walk in, take a number)  and the dr I seen has put in my notes for a mri. So when I see my regular GP Tuesday I will get the referral for the mri. Hooroo, harpy

  • @mjcg

    I literally had my PT tell me this a few weeks ago....he gave me some "literature " to read up on.

    I went back and said,  "yeah I know what you're saying (ie. Thinking)  but I DON'T agree since my MRI (just a few months ago) showed C4  degeneration and C5 C6 stenosis,  L4, L5/S1 bulges with posterior impingement" 

    So yeah but no....

    I'm sorry you experienced this too, but as everyone else said,  don't let them try to fob you off.

    I'm glad you're feeling a bit better after the ablation,  I hope it continues. 

    Best wishes 


  • As always, I so appreciate everyone who has responded to my post.  This morning, unfortunately, I woke up with the same old terrible back pain.  This likely means the radio frequency ablation did not work.  Ugh.  I sincerely apologize for my earlier excitement of thinking that the ablation was successful.  I'd still tell people in pain to go ahead and try it.  I did not think it was a difficult procedure and if you're like me, you'd do anything to stop this.  It's been over a year since this pain started.  I have done everything suggested by the spine specialist and PT.  Nothing has really helped.  Maybe it IS all in my head!?!   I surrender.  Sorry for rambling.  I'm tired and in tears. Hugs to all of you here responding, or just reading.  I wish the medical community could somehow help us.  I don't think it's all in my head.

  • mjcg - I've had RFAs in both my lower back and neck,  The lower back RFAs allowed me to rehab and "get back to normal".  In my neck, I had too much structural spine damage and had to resort to multiple cervical surgeries.  I was advised by the doctors that did the RFAs to give at least 10 to 14 days before even trying to evaluate if the RFAs did any good.  Anymore, it feels like to me that RFAs are often used in a dual purpose mode: (1) if they are therapeutic and sometimes followed by PT to result in manageable relief, then great and (2) if not therapeutic, they can sometimes help in the diagnostic process for possible other interventional approaches. 
     Please give your doctor that did the RFA(s) feedback.  I've heard many stories (including my own) that were NOT as simple as getting an MRI and having an immediate diagnosis.
  • Sorry to here your not so good today, NO don’t believe it’s in your head, don’t surrender to it . Fingers crossed it’s early days and it might settle. For your sake I hope so.  I understand how hard it is to hold your chin up, being Brave when your in chronic pain is so darn hard. I down loaded an app that has my doc on and I moved my Tuesday appointment to tomorrow ( Monday). I will as for my referral for my MRI, also want a head to tail mri. Harpy

  • @mjcg

    I'm so sorry to hear you're hurting,  I feel your pain, literally. 

    It is not in your head my friend. Please do not give up on finding an answer and God willing,  a solution. 

    Speak to the doctor that did the RFA, @stiffneck7 is right, you may need some other tests.

    Hang in there,  today may be a bad one, but there's light at the end of the tunnel.

    Don't give up.

    Hugs back at you.


  • I wish (oh so I wish!) I could meet each and every one of you in person and then take you out to dinner!  I can't tell you how much it means to me that there are people who understand, care, and freely share guidance and wisdom!!  That sounds so sappy, but I really mean it.  This morning the pain/numbness that flows down my leg is gone.  And my back just feels sore (not like a nerve is pinched).  So, it's better than yesterday thank goodness.  Of course, I've also downed the maximum ibuprofen allowed (and took a shot of Irish whiskey lol).   I have a follow-up appointment with the spine specialist in February so I'll see what he says.   I continue to send you all positive, healing thoughts along with my sincere appreciation.

  • What a difference a day makes.  I had so much energy and little pain today I decided to change the bedding (I know I know) and clean the outdoor patios and enjoy a fine 70 degree SoCal day.  This time I was sure to take it slow and rest when I needed it and maybe this kind of mindfulness will allow me to NOT be hurting tomorrow.  A little Bloody Mary vodka helps too on Championship Sunday (NFL)  

    It’s all we can do take it day by day, like Angie said there’s always a light at the end of the tunnel and one bad day does not mean the next day will be the same.  THAT is not in your mind, that’s reality. 

  • Well said, Joel1Q!  Keeping my fingers crossed for tomorrow.  Nice to see the Kansas City Chiefs in the game after 50 years.  Cheers!

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