Physicophobia is a concept which I have been familiar with for many years, but it was not a word that I actually heard applied to the idea until I read Dr. John Sarno’s many books.
In the dorsopathy sphere, I see this type of prevalent fear in so many patients and it is a major part of most chronic pain syndromes. Unfortunately, the fear is typically so powerful that it makes patients change their habits, activities and overall lifestyles, often limiting them to incredibly sedentary behavior patterns and an ongoing restlessness which can not be relieved.
If I had to put together a set of common attributes demonstrated by chronic pain sufferers with a wide range of diagnosed conditions, physicophobia would certainly make the top of that list. Basically, when a person has ongoing pain, they expect that too much physical activity will make things worse, and so it happens, in virtually every case.
This essay explores the fear of physical activity that is associated with back pain and many other causes of chronic health issues.
To put is simply, this term means a fear of physical activity. The extent and characteristics of this fear vary from patient to patient, with some people having specific phobias regarding particular activities, while others fear any vigorous movement at all. The reason for the fear is universal, however, in that the patient expects pain to result or intensify from the dreaded activity.
When it comes to back ache sufferers, this fear is often illogical and ungrounded, even when pain does present itself. This is because although activity-related pain is certainly possible, it is also generally easily cured once an accurate diagnosis has been made. When this specific pain tends to defy treatment, it is often related to the mindbody processes more than any structural irregularity which may or may not have been diagnosed.
Therefore, pain which comes on during particular or general physical activity is often due to a back pain conditioning syndrome, rather than a true anatomical source. Of course this is far from an absolute, but does provide some valuable food for thought.
Being afraid to do a few things is not overly limiting. However, it is no coincidence that many of the fears people have relate to activities they claim to enjoy or must do in order to fulfill their jobs or responsibilities. I see many cases of this including:
Runners who can do everything else, but get back pain when they run.
People who fear standing and must stand in pain for their jobs.
People who fear sitting and must sit in pain for their jobs.
Competitive athletes who are fine training, but get recurrent injuries while actually competing.
People who have illogical fears regarding specific activities, but not others which are often far more physically taxing.
Other patients have an overall fear of any sudden movement, any strenuous activity, any jarring impact or any type of bending or twisting at the waist. These are the most common general back pain prohibitions, but a seemingly endless number are possible.
Trust me, I have seen and heard it all from patients, including some truly illogical fears and phobias related to the occurrence of symptoms.
I also see many cases of the opposite behavior, including symptoms in myself which endure to this day. These are people who feel they must exercise in order to be pain-free. While back exercises are great for you, they should not be an obsession or a subject of fear hanging over one’s head.
I personally still get this feeling and often succumb to the urge for some basic activity, even when I would like to simply relax. Reverse physical phobia? Maybe. How about relaxophobia? lol...
The point is simple, physical activity is rarely the actual villain or savior. It is more often just part of the conditioning process that all back pain sufferers go through regardless of what type of symptoms they have. Some of these illogical conditioned behaviors and reactions can be laughable when viewed objectively, but they are certainly never funny from the affected person’s point of view. Doctors must keep this in mind when discussing these issues with their patients, in order to avoid alienating or mocking what the patient truly believes to be right.