Have you ever felt a sharp ache in your back after a stressful day or sleepless night? Maybe you blamed a bad posture or an old mattress, but stress and anxiety might be the hidden culprits behind your discomfort.
Written by
Angel Rigueras
Pain Management Specialist
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Written by
Angel Rigueras
Pain Management Specialist
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Low back pain (LBP) is a common health problem worldwide, significantly impacting quality of life by causing activity limitations, interfering with daily routines, and leading to difficulties at work.
The pain may begin after a specific incident and can be exacerbated during periods of stress, often associated with emotional factors, fatigue, and sleep disturbances. One method of classifying the causes of low back pain can be as specific or nonspecific.
For this reason, it is important to exercise caution when attempting to self-diagnose LBP, as the pain could be indicative of a serious medical condition involving specific spinal issues or non-spinal causes, including infections or diseases of the pelvic organs, among others.
In the following text, we will explore how stress and anxiety may be connected with low back pain, how to identify these issues, and potential treatments to help alleviate the pain.
According to the American Psychological Association (APA), stress and anxiety are distinct emotional responses.
Stress can be defined as a process by which a challenging emotional or physiological event or series of events results in adaptive or maladaptive changes required to regain homeostasis or stability. Stress usually comes from external triggers, like work deadlines, arguments, or family conflicts. Everyday challenges like these can build up over time. Long-term stressors may include unemployment, discrimination, financial difficulties, or illnesses.
When experiencing stress, individuals may face both mental and physical symptoms, including headaches, irritability, anger, fatigue, muscle pain, digestive issues, difficulty making decisions, avoidance of certain places or people, and trouble sleeping.
On the other hand, anxiety is defined as excessive and persistent worry that continues even in the absence of a specific stressor. People with an anxiety disorder may experience intense fear or worry about particular situations (such as a panic attack or social interaction) or, in the case of generalized anxiety disorder, about a wide range of everyday situations. These symptoms typically persist for an extended period—at least several months—and individuals often avoid situations that trigger their anxiety.
According to the National Institute of Mental Health, 31% of Americans will experience an anxiety disorder at some point in their lives. The symptoms of anxiety are similar to those of stress and include insomnia, difficulty concentrating, fatigue, muscle tension, and irritability. Other symptoms may include trouble making decisions, nausea or abdominal distress, heart palpitations, sweating, trembling or shaking, and a sense of impending danger, panic, or doom.
Anxiety and stress are natural survival mechanisms that help animals adapt to their environment, both challenge the homeostasis of the body and the necessity of decision-making.
In our brain, the region known as the limbic system plays a crucial role in learning. This system includes the hippocampus, amygdala, and ventromedial prefrontal cortex. These areas integrate incoming nociceptive or stress signals with the internal state and generate learning signals essential for decision-making. As a result, when the physiological and structural functions of this learning circuit are observed in conditions such as pain, depression, and post-traumatic stress disorder, an association has been observed and described.
Furthermore, pain can be defined as a combination of emotional and sensory perceptions, along with motor behaviors, that arise from the activation of nociceptive pathways in response to harmful stimuli.
While both pain and stress serve adaptive roles in protecting us, when either process becomes chronic, it can lead to long-term maladaptive changes in physiology and behavior. This, in turn, results in suffering and compromised health. Chronic stress and chronic pain share a common behavioral model characterized by an inability to extinguish negative memories.
Clinical studies exploring the association between pain and stress have found that chronic stress can disrupt your body’s hormone levels and inflammation processes, worsening pain. These issues with cortisol and inflammation contribute to oxidative stress, free radical damage, cellular injury, accelerated aging, and tissue degeneration, all of which can aggravate an injury’s symptoms, such as pain.
The first model studied is chronic back pain (CBP), as pain is considered a form of stress that places significant strain on the patient. CBP is conceptualized as a state of stress overload, which increases the risk of dysregulation of physiological systems, resulting in compromised well-being and social or occupational dysfunction.
Patients experiencing persistent pain may overburden the brain, leading to deficits in decision-making. Conversely, a fear of movement that might exacerbate pain can result in a more sedentary lifestyle (i.e., inactivity), contributing to such consequences as weight gain and deconditioning.
Stress can influence low back pain through several mechanisms:
Back pain symptoms that stress may aggravate are:
The association between stress and low back pain is often made by a thorough medical history and physical exam. If the back pain is persistent and becoming chronic, pharmacological or nonpharmacologic interventions may be considered and recommended by your doctor.
If a connection between back pain and stress or anxiety is identified during your medical history and diagnosis, neurological, psychiatric, and/or psychological interventions are crucial for treating anxiety and stress disorders. Psychological interventions primarily involve talk therapy with trained professionals. Such therapies can help patients develop new ways of thinking, coping, and relating to their anxiety, others, and the world around them.
During long-term experiences of pain and stress, patients tend to face social isolation, dissatisfaction at work, social conflicts, and heightened worries. Managing pain and identifying the triggering events related to anxiety can play a significant role in reducing pain-related symptoms.
A multidisciplinary approach to addressing the stress-related components of back pain involves evaluating physical, emotional, cognitive, and environmental factors across all types of back pain problems and developing treatments for each aspect. As such, a multidisciplinary program may include the following treatments:
At UOC our behavioral health specialists are ready to guide you through this vital aspect for a fulfilling life.
When managing the physical and emotional factors contributing to back pain, medications may be necessary. Such medications may include anti-inflammatory drugs or muscle relaxants.
To treat anxiety, stress, or post-traumatic stress disorder (PTSD), there are a wide range of options available, depending on your doctor’s recommendation. The most commonly prescribed medications include:
Before considering a surgical intervention, non-surgical alternatives are available for managing back pain.
UOC offers these treatments through board-certified specialists ready to assist you with all your needs, whether you require surgery or non-surgical procedures.
Non-surgical treatments offered by our clinic include:
and other specialized treatments such as
However, it’s important to note that if non-surgical treatments fail to improve symptoms, surgical intervention may be considered, and you should consult with your specialist doctor.
Surgical options offered by our clinic include:
Arthroscopy and Spine Surgery.
Don´t forget that addressing symptoms of back pain augmented by anxiety or stress starts with small, consistent changes to your lifestyle, daily habits, and psychological accompaniment.
We understand how living in pain, feeling overwhelmed with worry, always tired, and sleepy, and canceling social plans just to stay in bed, is no way to live.
At University Orthopedic Care, our dedicated team provides comprehensive, multidisciplinary care tailored to your pain management needs, with interventional pain medicine, neurosurgery, orthopedics, psychological and neuropsychological support, and physical therapy every step of the way.
Don’t let pain, anxiety, or stress control your life. If you’re struggling with persistent pain, discomfort, and unshakable worries, take the first step toward relief today. Call us at (866) 962-1744 or conveniently request an appointment online.
