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Study: Spouse Criticism Can Actually Increase Your Chronic Low Back Pain

February 5, 2018

According to a recent study, if you were diagnosed with chronic lower back pain, you may feel it worse if your spouse is judgmental and unsupportive of your condition.


Specifically, women with back pain, as well as those with depression are the most susceptible —whether it's actual or perceived turbulent communication from your significant other, the study authors report in the online journal Pain.

“Most studies of spouse and family interactions with people with chronic pain have focused on the positive effects of adequate social support,” remarked lead author, Dr. John Burns of Rush University in Chicago, Illinois.

In a prior study, he found that negative responses appear to function in a cycle. Spouse criticism can actually enhance your pain, even up to three hours following an argument and personal pain such as grimacing, crying or hurting can drive spouse criticism up to three hours later.

“These (new) findings point toward the harmful effects of specific negative spouse communication directed toward pain patients,” he replied. They can shift the foundation of marital interventions that target the decrease of criticism, Burns continued.

The Specifics

Burn's team followed 71 couples through a series of 10-minute interviews. They observed spouse attitudes on how those with degenerative disc disease, spinal stenosis, and herniated discs could improve their capacity to cope with their back pain.

The authors note that although the discussion was designed to initiate conflict, the measure of critique wasn’t manipulated. After the initial interview, the spouse with back pain did a 10-minute structured exercise that involved sitting, standing, walking, reclining, bending and stretching to raise an object as the other observed.

While all of this transpired, the researchers measured the apparent criticism from the spouse, perceived criticism on the patient's part, in addition to the patient’s pain severity, pain responses, and depressive symptoms.

Throughout each discussion, researchers discovered that all the patients reported feeling notable increases in anxiety, anger, and sadness.

During the pain patient's activity, those with larger depression scores were additionally more likely to perceive spouse criticism and feel more intense pain. Furthermore, the greater hostility from the spouse, the higher depression, and pain scores were for the pain patient.

After the researchers adjusted their results for other factors that may influence pain, they found that the link between spousal hostility and patient pain levels only remained statistically significant for women back-pain patients.

“Because the study required both patient and spouse to cooperate enough to participate, they generally got along just fine,” Burns stated. “Even with these fairly happy couples, spouses uttered enough critical and hostile comments too negatively affect patient pain and function.”

What it All Means

The research team was shocked by how each spouse seemed genuinely concerned about the other person's pain throughout the discussion and would ask if this task would inflict pain. Yet, those spouses who intended to supply “helpful” recommendations to the pain patient were also considered critical.

For those with chronic low back pain, you may see that marital problems are common and often quite significant, but in most current pain management approaches, these issues are often addressed inadequately, if at all.

“It is surprisingly easy to respond to a loved one by dismissing their experience, criticizing them, or reacting with hostility or contempt,” told Dr. Annmarie Cano of Wayne State University in Detroit, who wasn’t directly involved in the study. “But these responses are painful, not only psychologically but physically as well.”

Burns and his team are developing a proposal for another randomized study, testing the effects of anti-criticism on marriage relationships.

“Research to date has suggested that the best type of support is one that helps patients live the best life they can despite their pain,” answered Kevin Alschuler of the University of Washington in Seattle, who also wasn’t involved in the study.

The Take-Away

Instead of criticizing one another, get busy, together. Engage in normal activities that the pain patient and spouse alike can do unitedly. Think outside of the box. Consider seeing a movie together, allowing the non-pain patient to choose what you see. Or try a mediation session where you both can get your zen on while bonding in a unique fashion. Regular meditation can work to lower the body’s level of pain as well as improve sleep.

While at the same time, stay active, together. Start small. Instead of driving to that appointment or errand, try walking there together. It doesn't have to be a sprint, just whatever your bodies can handle. If walking to an appointment will not work due to your location or the patient's pain levels, go for that leisurely walk around your neighborhood with one another. The vitamin D and wind on your faces should improve your mood and allow you to take that break from the household monotony.

Married couple walking down the street holding hands.Caption: Newlyweds, Christina (left) and Brad (right) walk hand in hand to a local chiropractic appointment.

“This requires a careful balance, as missing the mark can contribute to greater pain, less activity, lower mood and lower quality of life,” Alschuler wrote to Reuters Health via email. “The best support encourages activity and engagement but is also sympathetic to the challenges the person with pain faces.”

Last change: February 5, 2018
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