Is Back Pain Physical or Emotional? A Physical Therapist Explains the Truth

In this episode, Dr. Ryan Peebles, Doctor of Physical Therapy and founder of Core Balance Training, explores the mind–body connection in back pain and addresses a common question from students, “How emotional and psychological factors interact with physical causes of pain.” Drawing from clinical experience, student questions, and influential ideas such as Dr. John Sarno’s work, Ryan explains why back pain is rarely only physical or only emotional and why a combined, holistic approach leads to better long-term outcomes. This episode covers: What the mind–body connection really means in chronic back pain A student question that sparked the discussion: emotional vs. physical healing Dr. John Sarno’s theory of repressed emotions and tension-based pain Why muscle tension and reduced blood flow can create real pain How posture, joint friction, and muscle imbalances contribute to degeneration Why emotional stress can worsen existing physical back problems How chronic pain can create fear-based movement and reinforce dysfunction When back pain may start emotionally and later become physical Why modern lifestyle factors (sitting, screens, stress) are driving back pain rates up Why addressing both emotional awareness and physical mechanics matters Core stabilization as the foundation for spinal protection Why slow, mindful progress beats intensity in rehab The role of breathing as the “foundation of the foundation” How excessive effort can increase tension and delay healing Understanding left–right vs. front–back imbalances Why unilateral training helps correct asymmetries The importance of movement quality over forcing strength How fear, stress, and rushing can instantly worsen symptoms Practical reflections to reduce emotional tension in daily life A holistic view: awareness, patience, and consistency over quick fixes Watch the free Core Balance Masterclass and start your 7-day free trial to experience the Back Anchor lesson firsthand and begin retraining your movement patterns from the inside out: https://www.corebalancetraining.com/masterclass Disclaimer: All content is for educational purposes only. Consult a qualified healthcare professional before beginning any exercise or rehabilitation program. Episode Chapters: 00:00:00 – Introduction: The mind–body connection in back pain 00:02:10 – A student’s question that sparked this discussion 00:04:15 – Dr. John Sarno’s theory: emotional causes of back pain 00:07:00 – How stress and tension create real physical pain 00:10:10 – Do emotional and physical causes overlap? 00:15:20 – The perfect bridge pose & the mattress you use 00:18:15 – Activating core muscles 00:22:50 – Back anchor progression and Breathing in core control 00:25:00 – Student Q&A: Doing a typewriter squat 00:28:40 – Student Q&A: Will CBT help with back pain symptoms? 00:32:50 – Having the right posture for exercises 00:36:15 – Student Q&A: How to walk uphill 00:37:45 – Connecting better with body and body imbalances 00:41:50 – Front anchors and Push away explained 00:48:30 – Final thoughts: awareness, and mind-body connection