Citation

Volinn E, Loeser JD. Yale J. Biol. Med. 2022; 95(1): 153-163.

Copyright

(Copyright © 2022, Yale Journal of Biology and Medicine)

DOI

unavailable

PMID

35370485

PMCID

PMC8961709

Abstract

Chronic back pain (CBP) is a common symptom throughout the world, and those undergoing it often experience a profound degradation of life. Despite extensive research, it remains an elusive symptom. In most cases, CBP is "non-specific," since bio-mechanisms examined in the clinic do not account for it; another way of saying this is that it is "of obscure origins." This paper re-directs attention towards origins that are distal and usually out of sight from the vantage point of the clinic. CBP as considered here is non-specific, persists ≥ 3 months, and, additionally, interferes with activities of daily life, such as family interaction or work. A theory proposed in the paper draws upon Durkheim's Suicide to explain why exposures in the distal social contexts of family and workplace are fundamentally implicated in CBP. The theory is formed out of previously published studies on family and workplace social contexts of CBP and, in effect, provides a theoretical framework with which to review them. After treatment of CBP in the clinic, patients return to family and workplace contexts. Unless exposures in these contexts are addressed, they serve as continually renewing sources of CBP that remain unabated regardless of mechanism-based treatment in the clinic.

Language: en

Keywords

Humans; Workplace; Social Environment; Durkheim; Back Pain; Bio-Psycho-Social Model; Chronic Back Pain; Family Context; Non-Specific Back Pain; Social Aspects of Pain; Social Theory; Workplace Context