Back pain a physical–and mental–burden
By Greg Chapman
New CQUniversity-led research has revealed back pain goes beyond the physical with millions of Australians bearing an equally debilitating mental load.
Conducted by CQU’s Senior Lecturer in Chiropractic, Dr David McNaughton, in partnership with other CQU researchers, Macquarie University, and MindSpot, for the Australian Chiropractors Association (ACA), the findings showed sufferers of musculoskeletal disorders (MSDs) need more holistic support.
“Back pain and musculoskeletal pain are among the leading causes of disability in Australia and are a major burden on individuals and the healthcare system,” Dr McNaughton said.
“Our research looked at whether clinicians treating back and musculoskeletal pain could better support patients by recognising that pain is often connected to mental wellbeing. We explored whether adding access to an online psychological pain management program alongside usual musculoskeletal care could improve support for patients.”
According to an independent survey conducted for the ACA, 87.1 per cent of Australian adult respondents had experienced back pain in the past 12 months, with almost 69 per cent of those reporting it impacted their mental health.
More than six million Australian are already affected by MSDs, of which 58 per cent are of working age in peak-income earning years (25-64) with the annual cost to the Australian economy at more than $55 billion, according to a Deloitte survey.
Dr McNaughton said the key finding and message of his latest research was that pain is rarely ‘just physical’.
“Many patients experiencing ongoing pain also experience stress, worry, fear of movement, sleep disruption, or changes in mood, all of which can influence recovery,” he said.
“We found patients and clinicians generally valued a more psychologically informed approach, although barriers such as time, confidence, and understanding still exist when implementing this in routine practice.”
He said recommendations from the research included adopting a biopsychosocial and psychologically informed approach to musculoskeletal care.
“This does not mean chiropractors become psychologists, but rather that clinicians are supported to better understand how stress, mood, beliefs, confidence, and coping can interact with pain and recovery,” he said.
“For patients, this can mean feeling more understood, receiving more holistic care, improving confidence and self-management, and being directed to additional support when appropriate. For the profession, it supports more contemporary, evidence informed practice and strengthens collaboration with broader healthcare providers and in this particular case, MindSpot a national Digital Mental Health Service.”
As Senior Lecturer at CQU, Dr McNaughton said chiropractic students were increasingly trained to see pain through a biopsychosocial lens, recognising that physical, psychological, and social factors all contribute to a patient’s experience and recovery.
“If psychological factors are overlooked, there is a risk that care becomes too focused on symptoms or structure alone, potentially missing important contributors to persistent pain,” he said.
“Patients may continue to experience repeated flare ups, frustration, uncertainty, reduced confidence, or delayed access to psychological support when needed. This can contribute to poorer long-term outcomes and greater disability.
He said more research would be conducted around the biopsychosocial management of back pain and MSD.
“This research represents an important first step in understanding how psychologically informed approaches can be integrated into musculoskeletal care,” he said.
“Future research will explore how these approaches can be scaled, refined, and implemented more broadly, including how clinicians can be better supported through education, training, and digital care pathways to improve patient outcomes.”
Read the Australian Chiropractors Association media release.
