Can Stress Cause Back Pain?

Back pain is one of the most common health problems. Whether that’s lower back pain, upper back and neck pain or middle back pain, it something most of us will experience at some time in our lives. The question everyone wants to know is what causes back pain?

Often it can be easy to put back pain down to purely external or mechanical factors; like an uncomfortable bed or chair, heavy lifting, or structural changes like arthritis or a disc bulge. While these can be relevant, when we experience back pain there is always a constellation of different factors at play together, some of which you may not have considered. When then there is no clear injury or mechanical factor people can feel confused that they have back pain for no reason. Factors related to lifestyle, mood, and stress are often overlooked, but can be key to you understanding and healing from back pain.

Has lockdown left you feeling stressed out? With an unfocused or racing mind? Or suffering aches and pains?

Over the last decades medical science is showing a clear link between physical and mental health. Stress, depression, anxiety, and sleep quality all have a relationship with our experience of pain (1).

The link between stress and pain is one that many people make intuitively. A recent UK lockdown study of 500 people found that over half experienced new aches and pains during lockdown, especially in the back, neck and shoulder (2). Another UK lockdown survey of 2000 people, found over a third experiencing new back pain, neck pain, joint pain, headache, or muscle pain during lockdown. Half of those felt that stress was a key factor (3). 

Is stress bad for you? Are you stressed, or ‘stressed out’?

Stress is our body’s natural response to living life. It’s how our mind and body are motivated and mobilised to take action. Our stress response is natural and normal. We need it whether we are moving towards what is important to us, or trying to move away from what we don’t want.

We need our stress response, in itself it is not bad. In fact exposing ourselves to some stress is good for us, for example vigorous exercise is anti-inflammatory and strengthens your immune system (4).

If you are living with unrelenting life stressors, then an ongoing stress response can cause problems for your mental and physical health. This is when your management of your stress response is key. This can make the difference between you being more or less prone to physical pain or mental suffering. This is true whether you become unknowingly ‘stressed out’, or knowingly ‘distressed’ by the levels of stress in your life. The health of our mind and body are closely linked (5,6,7). And once we have back pain then stressful events or depression can contribute to flare ups (8).

What are the signs of being too stressed or ‘stressed out’? 

For some people being ‘stressed out’ comes in the form of increased mental thought, worrying about the past or the future as the mind tries to problem solve. Some people can have a sense of unrelenting ‘white noise’ in their mind, and can’t relax. Some may go the other way experiencing low mood, feeling unmotivated or ‘numb’. In either case being ‘stressed out’ also manifests in our body, for example by having increased levels of inflammation, changes in breathing pattern or increased muscle tension and guarding. This can contribute to aches and pains, which can then cause more worry and stress. We end up in a cycle of the body and mind responding negatively to each other and keeping us over stressed physically and mentally. 

Signs of stress: 

Anger, irritability, or discontent and restlessness.
Feeling overwhelmed, unfocused, low in energy or unmotivated.
Aches, pains and feelings of muscle tension.
Trouble sleeping, or sleeping too much.
Racing thoughts or constant worry.
Problems with your memory or concentration.
Changes in appetite; wanting to eat more, or to eat less.
Loss of sexual desire or ability.
Digestive problems like upset stomach, bloating, diarrhoea, constipation, or nausea.
Frequent colds or infections.

How to manage and relieve stress? 

It’s no surprise that the challenges of the coronavirus pandemic are leading to increases in psychological stress, as well as aches and pains. Any ongoing situation can be challenging e.g. an unsolvable dilemma at work or home, or any ongoing home, work or health pressure. We can’t just stop stressful events like financial pressure, loneliness, relationship pressures, worrying about loved ones, etc… But we can optimise our stress response. And remember our stress response is natural and normal. It’s also how our mind and body are motivated and mobilised to move towards what we want and value.

As well as the added stress of the coronavirus pandemic we have also been limited in the natural ways we manage stress- like socialising, exercising and holidays. Often when we are stressed out, our desicion making, motivation, and focus suffer. We end up taking actions that make us worse, and don’t take action that could help. This is normal. If we get stuck it is also normal that we may need some help to move forward. 

Most of us are already aware of what helps when we are stressed:

Exercise (9) 
Laughter & Play (10) 
Socialising  
Sleep & Rest 
Good Diet 
Meaningful Activity/Work 
Learning To Respond Mindfully And Skilfully To Your Thoughts And Emotions (even the unwelcome ones!) 

But just knowing what can help, doesn’t always mean that taking action comes easily, especially if we are already stressed out! For example socialising, laughter and play might help but they don’t come naturally if you are fatigued, worried or in pain! (10).

It is normal for our mind to produce unwelcome, difficult thoughts and feelings. Sometimes fighting or trying to avoid these helps temporarily, but causes us more problems and stress in the long term! Instead we can develop healthy ways of responding to all our thoughts and feelings. You can learn to accept what our human mind does naturally, and still live in line with what is important to you: being true to yourself, and to how you want to treat others, yourself and the world around you.

How Can Orson Wajih Physiotherapy Help You Manage Stress?  

• Having a confidential space to explore and understand how stress is impacting your life.

• Exploring ways of accessing your own inner resources, wisdom and creativity to increase your vitality and satisfaction in life.

• Learning to navigating life situations where there are no easy answers, living with difficult dilemas.

• Finding satisfaction and value in life even when circumstances are against you.

• Exploring what is meaningful and valuable to you, and finding the motivation to act towards that.    

• Finding your motivation to take meaningful action to improve and maintain your health, and to change unhelpful habits.

• Expert diagnosis of any physical injury and individualised exercise advise. 

• Bodywork massage, which is shown to help stress, anxiety and depression (11, 12, 13). 

If you would like to explore more about how managing stress can help you within the  Calm, Energy and Resilience Program that I am offering, please email or call me on  0207 235 3471 for a FREE Discovery Session. 

References

1. Hannibal KE and Bishop MD. Chronic Stress, Cortisol Dysfunction, and Pain: A Psychoneuroendocrine Rationale for Stress Management in Pain Rehabilitation. Phys Ther. 2014. 

 
2.https://www.employment-studies.co.uk/resource/ies-working-home-wellbeing-survey 

 
3.https://www.prnewswire.co.uk/news-releases/lockdown-living-may-cause-a-third-of-brits-more-pain-as-new-prevention-guidance-issued-846364791.html 

4. The compelling link between physical activity and the body’s defense system, Journal of Sport and Health Science Volume 8, Issue 3, 2019, Pages 201-217, 

5. K. A. Davies, G. J. Macfarlane, B. I. Nicholl, C. Dickens, R. Morriss, D. Ray, J. McBeth, Restorative sleep predicts the resolution of chronic widespread pain: results from the EPIFUND study, Rheumatology, Volume 47, Issue 12, December 2008, Pages 1809–1813, 

6. Front. Public Health | doi: 10.3389/fpubh.2020.00297 Perceived Stress and Low-Back Pain among Healthcare Workers: Prospective Cohort Study Jonas
Vinstrup1*, Markus D. Jakobsen1 and Lars L. Andersen1 

7. Martinez-Calderon J, Flores-Cortes M, Morales-Asencio JM, Luque-Suarez A. Which Psychological Factors Are Involved in the Onset and/or Persistence of Musculoskeletal Pain? An Umbrella Review of Systematic Reviews and Meta-Analyses of Prospective Cohort Studies. Clin J Pain. 2020;36(8):626-637 

8. Do Physical Activities Trigger Flare-ups During an Acute Low Back Pain Episode?: A Longitudinal Case-Crossover Feasibility StudySuri, Pradeep MD, MS*,†,‡,§; Rainville, James MD‡,§; de Schepper, Evelien MD¶; Martha, Julia MPH‡; Hartigan, Carol MD‡,§; Hunter, David J. MBBS, PhD‡,|| 

9. Journal of Anxiety Disorders Volume 76, December 2020, 102311 Working out the worries: A randomized controlled trial of high intensity interval training in generalized anxiety disorder JensPlag et al 

10. Gómez Penedo, Juan M. PhD*; Rubel, Julian A. PhD†; Blättler, Larissa MA‡; Schmidt, Stefanie J. PhD*; Stewart, Julian PhD‡; Egloff, Niklaus PD‡; grosse Holtforth, Martin PhD*,‡ The Complex Interplay of Pain, Depression, and Anxiety Symptoms in Patients With Chronic Pain, The Clinical Journal of Pain: April 2020 – Volume 36 – Issue 4 – p 249-259 

11. Baumgart S, Müller-Oerlinghausen B, Schendera CFG. Efficacy of massage therapy on depression and anxious disorders as well as on depressiveness and anxiety as comorbidity–a systematic overview of controlled studies. Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin 2011;21(4):167–82.  

12. Moyer CA. Affective massage therapy. Int J Ther Massage Bodywork. 2008;1(2):3–5.  

13. Psychol Bull. 2004 Jan;130(1):3-18.A meta-analysis of massage therapy research. Moyer CA1, Rounds J, Hannum JW.