Why Does My Back Hurt When Nothing's 'Wrong'?

You’ve had back pain for weeks.

You finally book in with your GP.

Maybe you even get a scan.

And the verdict?

“Everything looks normal."

So why are you still in pain?

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▸ Pain Doesn’t Always Mean Damage

This might surprise you, but **pain isn’t always a sign that something is broken.**

In fact, modern pain science tells us that pain is more like an **alarm system** — one that can sometimes become *too sensitive*, even when the danger has passed.

Think of it like a smoke alarm going off just from burnt toast. There's no fire… but your alarm doesn't know that.

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▸ The Biopsychosocial Model: A More Complete Picture

To really understand back pain — especially when scans and tests show “nothing wrong” — we need to look beyond the physical.

Pain is influenced by a mix of **biological**, **psychological**, and **social** factors. This is called the **biopsychosocial model**, and it’s backed by decades of research.

Let’s break that down.

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# 1. Biological Factors

These include things like:

* Previous injuries

* Muscle tension or joint stiffness

* Your general physical health

* Sleep quality

* Inflammation

But these don’t act in isolation.

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# 2. Psychological Factors

Your **thoughts**, **beliefs**, and **emotions** can all play a role in how much pain you feel.

For example:

* If you’re anxious or stressed, your brain may interpret signals from your body as more threatening.

* If you believe you're “damaged” or fragile, you may avoid movement — which can ironically increase stiffness and pain.

This isn’t saying “it’s all in your head” — far from it.

It’s saying your *nervous system* is part of the story.

Vlaeyen & Linton (2000) describe this in the **Fear-Avoidance Model**, where fear of pain leads to avoidance, which can then increase disability.

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# 3. Social & Lifestyle Factors

The context of your life also matters:

* Are you under a lot of pressure at work?

* Are you getting enough rest?

* Have you been sitting more than usual?

Pain often arises not just from *what happened*, but from *everything going on around it*.

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▸ The Role of Sleep and Stress

A lack of good-quality sleep can lower your pain threshold and increase inflammation in the body.

Even one poor night’s sleep can make your body feel more achy and sensitive.

Haack et al., *Sleep* (2007) found strong links between **sleep loss and increased pain sensitivity**.

Likewise, ongoing stress can “turn up the volume” on pain by keeping your nervous system in a more protective, reactive state.

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▸ So... What Can You Do?

The good news?

Understanding this broader view of pain opens up **new and effective options for healing**.

Here are a few key things that help:

* Move gently and regularly — even if it’s just a little to start with

* Build confidence in your body again through guided rehabilitation

* Improve your sleep routine and stress management

* Work with a practitioner who listens to *your whole story*

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▸ Final Thoughts

Pain without injury doesn’t mean it’s “in your head.”

It means your body and brain are trying to protect you — sometimes a little too well.

If you’re dealing with persistent back pain, know that **there is hope, and there is help**.

Osteopathy can be a supportive step in understanding your pain, restoring movement, and getting back to living the life you want.

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Need support or a fresh perspective on your pain?

Feel free to get in touch — I’m here to help.

Ella x