Is “Stress” the new “Low Back Pain?

I was having a coffee with a friend the other day who I had not seen in ages, and instead of the expected “Hi mate, long time no see, how’s things?” His first response was “Wow what a stressful week I’ve had” and it got me thinking…….is “Stress the new Low Back Pain?”

Being a qualified Chartered Physiotherapist for over nine years now I have seen a big change in the type of patient complaints that come into my clinic.  When I started out as a Junior Physiotherapist there was a big epidemic of “chronic low back pain” patients coming into the musculoskeletal department. Today I see patients complaining of more generalised aches, pains, muscular tightness and tensions in various areas of the body.   When I take the patients subjective history, of how and when these symptoms started a common answer I get is “it just came on, it does this now and then for no apparent reason” or “well I have been stressed this week” or another common answer is “my anxiety has been bad this week, which seems to increase my pain”.

It is clear to see that the general everyday person has already made the link between feeling stressed with having aches and pains, and physical areas of increased muscular “tightness” or tensions.   When I objectively assess these patients they usually have significant tenderness in their tissues and a change in tissue quality on palpation. I refer to this as tonal changes in the skin and other deep tissues, including muscles. But I never see any objective signs of injury as to be expected from the clear subjective history.   

These presentations explained above are certainly on the rise in my clinic, and more and more people contact the clinic complaining of “muscular tightness”.  So this begs the question is stress the cause of these insidious presentations of increased “muscular tightness” and “aches and pains” that so many of us are reporting.  

We know that when we experience a stressor that our body undergoes many immediate physiological, psychological, behavioural, and biochemical changes as it undergoes the stress response.   If the stressor is only short lived the bodily systems quickly return back to their baseline, a term known as “homeostasis”. However if the stressor sticks around for a long duration, then problems can arise.  

Changes are happening

One highly documented change is that to the physiological system, which presents itself as increased muscular tension.  We also experience changes deep at the muscle cellular level known as our biochemical changes. Thirdly we may experience behavioural changes in our body language, in which we hold ourselves tense.   

Understanding these changes to our physiology when experiencing a period of stress now makes sense as to why so many people present with musculoskeletal aches, pains, and “muscular tightness”.   From experience this appears to present itself commonly in the muscles of the low back and neck muscles.

So in answering the question is “Stress the new Low Back Pain?” my answer would be that stress is a major contributor in many of these non-specific presentations of musculoskeletal aches and pain that are often described by the patient as low back pain.

If you are reading this and thinking “this is me, I ache all the time for no apparent reason”,  or maybe you have had back or neck pain for a number of years with no specific mechanism of injury, and you have just put it down to “getting older” perhaps?  If this sounds like you then maybe you are missing this link.

At Make Space our professionals carryout various assessments and tailored treatment programmes to manage common symptoms of the stress response mentioned in this post.  We identify the “why” and give you tools to live free of these unwanted aches and pains. If you feel we could assist you please do not hesitate to get in touch.

As always be mindful!