People with stress
Stress is one of the factors that increases the risk of back pain,
but there are steps we can take to prevent and control it.
What is it that increases the risk of back pain in people
with stress?
Studies to measure this effect have produced contradictory results,
but it is accepted that stress disturbs the nerves that control
the state of contraction of the muscles, thus facilitating spasm.
In this kind of situation, muscle spasm occurs with only very minor
efforts, or even spontaneously, causing bouts of pain.
Stress can also facilitate spasms by interfering with the coordination
of the different muscle groups involved in the functioning of
the back. In normal conditions, the different muscle groups involved
in back function, such as the abdominals and the paravertebral musculature,
coordinate with one another to maintain a posture or maintain balance
in movement. This coordination depends on nervous reflexes. Stress
may affect the coordination of these reflexes, causing the muscles
to contract in the wrong way or at the wrong time, thus facilitating
spasm.
The principal mechanism whereby stress can cause exposure to back
pain appears to be the facilitating of muscle spasm, but there can
also be other factors:
Because of the nervous structures that are activated when there
is stress, this can also lower the pain threshold, so that
the pain is perceived as more intense than it really is.
Stress can foster an attitude to pain that in itself increases
the risk of pain occurring or lasting longer. The features of this
attitude are:
Pessimism with respect to the pain, in that we assume that
it will go on indefinitely and will always constitute a limitation
on our ability and our quality of life.
Fear of pain and limitation of activity to avoid
it, overuse of symptomatic medication and abandonment of any task
which causes the slightest increase of the pain or which we believe
may do so even if it does not.
Lack of confidence in one's ability to control the pain
and the disability that it entails, and shifting of the responsibility
for doing so on to others - i.e., doctors or other health professionals.
The convergence of other risk factors in persons with stress,
such as sedentariness or excess weight.
Can back pain have harmful consequences for a person with
stress?
Not normally, no. Around 80% of the population suffers
back pain at some time in their life, and the vast majority suffer
occasional, periodic or constant stress. Back pain may be an added
discomfort for someone with stress, but the fact of having it has
no consequences other than the discomfort that it entails.
Only in predisposed personalities will it provoke behavior
patterns that are psychosomatic (in which the subject learns
to convert psychological conflicts into physical symptoms), hypochondriac
(in which the subject convinces him/herself that he/she suffers
physical affections that do not exist in reality - or even believes
that he/she perceives the symptoms) or obsessive (in which the back
pain becomes the focal point of his/her life).
If stress persists for a long time and provokes bouts of back
pain of increasing frequency and duration, the pain can become
chronic. There is a neurological mechanism whereby the longer
back pain lasts or the more frequent it is, the greater is the risk
of it becoming chronic by itself, regardless of what originally
caused it.
What can we do to prevent or treat back pain in people with
stress?
Obviously, the first thing that has to be treated is the stress
itself. This means resolving whatever situations are causing it,
so as to reduce the stress if that is possible, or if it is not,
learning to live with it and handle it in as healthy a way as possible.
There are many psychological techniques for this. Where stressful
situations are isolated, it may be worth considering psychopharmacological
substances like anxiolytics, under medical supervision. Of course,
if you frequently suffer from stress, you should consult a doctor,
psychologist or psychiatrist.
There are also measures we can take to reduce the impact of stress
on back health:
Keep as physically active as possible. Besides being effective
in preventing back pain, regular physical activity can help channel
off the stress and minimize its impact. It may take as little as
getting used to making day-to-day journeys on foot rather than sitting
in the car, metro or bus, or taking the stairs up a few flights
rather than always taking the lift. If possible, it is even better
to do some aerobic sports like running or swimming. With 20 or 30
minutes on alternate days, you will begin to note a considerable
difference. If you are going to start doing a sport regularly, you
should first consult a doctor to assess your general condition and
you should observe the rules of postural hygiene in sports, with
which you can do almost any of them with less risk to your back.
Know and observe the rules
of postural hygiene. These teach you how to adopt everyday postures
and movements that involve the least burden for your spinal column
and muscles, thus reducing the risk of spasm.
Maintain and develop the back muscles. Training of the
muscles involved in back function reduces the risk of spasm. If
done correctly and regularly, some aerobic exercises like swimming
may be enough to keep your back muscles and your general physical
condition in good trim. Specific exercise programs for the back
are only effective for these muscles and not for general fitness,
but they require less time and can be alternated with aerobic exercises
when you have time. There is a section of this site that shows effective
exercises for this.
If you experience pain, you must apply the right treatment. This
site contains a section that lists all the existing treatments for
back pain, and there is another that indicates the common patterns
of treatments that have proven effective. |
Back Pain Research Network 
Webmaster
Cases studies 
