While there are many causes of low back pain, the stress connection is one of the most frequently seen situations clinically. The degree of severity can vary widely amongst patients but the fact that back pain is a $60 Billion dollar problem in the stressU.S. indicates we are obviously talking about a major health issue. Stress is defined here as anything that is having a negative effect on one’s nervous system which will result in musculoskeletal dysfunction and perhaps pain. Stress can be the result of dietary, physical, emotional, or occupational influences. It all counts and stress can be accumulative regarding the potential to impact our physiology in a negative manner.

The U.S. is one of the most stressful countries to live in. Americans work longer hours and take less time off than the rest of the industrialized world. To keep up with ever increasing demands many people are living like hamsters on a treadmill. Combine that anaerobic lifestyle with the Standard American Diet (SAD) and you have a recipe that guarantees physical ailments like low back pain, as well as make one a prime candidate for chronic degenerative disease. Americans consume more junk food (756 doughnuts per year per person, for example), more refined sugar, and use more prescription drugs than any other nation in the world. The different sources of stress also feed off each other to magnify the damaging effects. For example, someone who is emotionally stressed may find comfort in high sugar snacks or alcohol. Maybe that contributes to poor sleep and they take drugs for that problem. Of course the drugs have side effects and those may eventually be treated with more drugs, etc. All these short term solutions may exacerbate the stress response in the body.

Here’s what happens physically when we are under stress. The body secretes a stress hormone called cortisol that triggers a fight or flight reaction. This is very good if you are running away from a tiger, but it is not so good if one is constantly experiencing this reaction. Living like you have a 24 hour emergency is not healthy. Cortisol is not meant to be secreted constantly. Excess levels deplete the immune system, stop normal digestion, deplete bone density, burn out your adrenal glands, promotes obesity, and interferes with good brain functioning. Yes, stress makes one less intelligent. There’s also a toxic load put on one’s liver and kidneys. It increases diabetes risk, affects heart health, increases inflammation, etc. As you can see, constant stress is not a good thing.

What does this have to do with low back pain? Plenty. Under stress, it is the adrenal glands that must respond. If this goes on long enough the adrenals become fatigued. When this happens there are direct consequences to the musculoskeletal system. For starters, the nerves supplying the adrenals become affected. Nerves are two way streets. They can not only be affected at the spinal level of origin, but also peripherally, at their destination, and that signal transmits back to the spine. In the low back, the third lumbar vertebra is commonly compromised. Muscles are also involved. All muscles innervated by the irritated nerves involved could go into a contracted state and trigger points (painful localized spots in the muscle fibers) develop. Pelvic alignment gets compromised which causes further problems at the spine as it deviates in response to the pelvis.

There are muscle-organ relationships. The work of Dr. George Goodheart in the 1960’s has withstood the test of time. There are predictable muscle imbalance correlations with organ stress. In the case of the adrenal glands, one of the primary muscles involved is the Sartorius muscle. It is a major pelvic stabilizer as well as a prominent medial knee muscle. This is why so many people, especially athletes, injure their knees when stressed. When muscles are being affected, they don’t respond adequately to the functional challenges they are faced with. The other end of the muscle attaches to the pelvis, which will go posterior on the affected side and the sacro-iliac joint on that side will be affected. There may be pain in that joint directly or it could manifest in the low spinal area. Within the sacro-iliac joint are only ligaments. When inflamed, ligaments are very painful. The main muscle involved with the sacro-iliac is the gluteus maximus which is normally a very strong, anti-gravity muscle. It is involved with lifting and getting up and down. People with weakness will put their hands on their knees and push themselves up. In grocery stores, these people are leaning over their shopping carts to support themselves.

Treatment should be multi-faceted. Balancing the adrenals is a must. This needs to be done specifically based on individual needs, but some common supports are choline, licorice, ashwagandha, rhodiola, Siberian and American ginseng, and adrenal glandulars. Structural work focusing on involved nerves, vertebrae, and muscles can be of enormous benefit. I like techniques from Pain Neutralization Techniques and Quantum Neurology. I also incorporate Bach Flower Essences to help deal with emotional stress and recommend counselling when needed. Exercise is a must and is tailored to the patient depending on the severity of their symptoms. Focus is on strengthening extensor muscles and forward flexion movements must be limited. I often recommend Tai-Chi and Chi-Gong exercises. Proteolytic enzymes are great for pain relief and repair. Bromelain is a good one. A low carbohydrate diet is suggested and foods that support the adrenal glands are helpful. Foods high in organic sodium are necessary since sodium is lost in the urine under stress. Those include zucchini, squash, green beans, and celery. Natural anti-inflammatories are useful. Those include ginger, turmeric, yucca, and boswellia, as well as fish or krill oil.
This eclectic approach works very well clinically to get people out of pain and back to normal functioning again very quickly. It is one that addresses the cause of the pain and not just the pain itself which is a path to disappointing long-term results.