Stress and Back Pain

Many recognize that emotional stress or psychological factors can affect back pain, but did you know that stress can cause back pain to linger longer or increase in intensity?

Back pain can begin following a specific incident or injury, or without recognizable reason. It is common to have back pain caused by activity such as a long day of yard work, from maintaining improper posture or lifting technique, or following a trauma such as a fall or accident. However, pain may remain as a result of emotional factors long after the injury has healed.

In many cases, an underlying process may be present, such as degenerative disc disease or disc bulge as found on MRI images although the MRI findings may not be clinically significant and not the cause of the back pain. Specific symptoms related to stress and muscular tension can include back or neck pain, muscle aching, tender muscle points and sleep interference and fatigue.

The Effect of Muscle Tension

Emotions have a direct effect on the muscle system; thus, a direct effect on back pain. Personal stress leads to increases in muscle tension. Positional deviations or muscular imbalances can also lead to stress and tension. Occurrences of back pain are frequently correlated with periods of increased emotional stress or worsening posture. This creates a continuous cycle.

Stress causes increases in muscle tension, which reduces normal blood supply, nutrition, and oxygen to the tissues. Subsequently, these factors can prevent muscles from functioning properly resulting in increased pain within the muscle. These physical changes increase as stress and muscle tension are not released. Emotional factors can be fundamental to causing physical changes resulting in back pain. Experiencing pain causes people to feel more stress, thus creating a continuous cycle. The pain cycle characteristics include:

  • Increased physical limitations in daily living activities, including recreational and leisure activities
  • Decreased activity levels due to fears of pain and injury
  • Fear can be further "locked-in" when healthcare providers recommend "taking it easy" due to a structural diagnosis, which may have nothing to do with the pain you experience
  • Limitations in movements and actions that lead to physical de-conditioning and muscle weakening which results in more back pain.
  • Increased psychosocial reactions to back pain including reducing socializing, increased depression and anxiety.

Breaking the Cycle

Pain relieving devices such as hot packs, ice, electrical stimulators, ultrasound, and whirlpools can be used to reduce muscle tension. Massage treatments or muscle relaxers are also used to treat tension. These treatments can help to improve blood flow to the muscle and reduce the buildup of lactic acid, but they are typically temporary solutions. If stress continues to be a factor, or if improper posture persists, the cycle will likely begin again.

To truly break the cycle, emotional and postural stresses need to be addressed. Each person copes with stress and tension in life in different ways and should use methods suited to their individual needs. Various changes in a person's work station can be made or simple stretching exercises can be performed during the day, which can reduce the buildup of muscle tension. These simple recommendations are far more effective and lasting than anecdotal remedies. Many modifications are simple and exercises can be completed in a few minutes. Performed consistently, it will make a significant difference in the accumulation of stress that leads to pain.

It is a misconception that a two-week vacation in August or a relaxing weekend is sufficient to reduce stress. Remember, mini-vacations taken every day using relaxation techniques and stretches can be the difference between long term stress reduction/back comfort and living with back pain and fatigue.