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The often Overlooked Psychological side of Back Pain

So… While I continue to work on my first undergraduate thesis project I came across an interesting journal article I’d like to share!

What I think is interesting about this experiment was that back pained patients were able to improve though advice alone!

Even more so, the combined effects of advice + exercise had the greatest impacts!

It’s so interesting that this advice was delivered by a physiotherapist and centered around pain education, reassurance, and encouragement to gradually return to avoided activities using cognitive-behavioural principles (CBT).

CBT is not something that is normally administered by physicians or physios, nor is it something that they typically feel confident addressing (Nicholas et al., 2011) and usually refer out for.

This study addresses and shows the significance of often overlooked psychological factors associated with chronic back pain and injuries.

I think it’s also an interesting thought that having more physicians and physiotherapists deliver this specific type of advice with CBT could provide better access to assessment and care for psychological factors or conditions!

A very hopeful and prospective thought for those who continue to suffer and struggle from chronic low back pain, that fall through the cracks of clinical care, and for the future of back rehabilitation.


If you are interested in working towards overcoming your back pain book a free consultation with me today:


*DISCLAIMER - the content on my site is for informational or educational purposes only, and does not substitute professional medical advice or consultations with healthcare professionals


  1. Nicholas, M. K., Linton, S. J., Watson, P. J., & Main, C. J. (2011). Early identification and management of psychological risk factors (“yellow flags”) in patients with low back pain: A reappraisal. Physical Therapy, 91(5), 737–753.

  2. Pengel, L. H. M., Refshauge, K. M., Maher, C. G., Nicholas, M. K., Herbert, R. D., & McNair, P. (2007). Physiotherapist-directed exercise, advice, or both for subacute low back pain. Annals of Internal Medicine, 146(11), 787.

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