Stress and Back Pain

Our experience pain is not a result of a direct link between an injury to the body and the pain response that comes from the parts of the brain that interprets pain signals. These same parts of the brain that interpret pain signals also receive other types of signals, related to feelings of happiness, comfort and enjoyment. If the pain receiving parts of the brain are able to receive enough comfort signals, related to activities that make us happy, these comfort signals may compete with the pain signals, to mute our experiences of pain or override them. This theory may seem counterintuitive to some of us, but it is a fact that is supported by a lot of modern research. It is a fact that people with stress, depression, and anger in their lives are more likely to experience chronic pain. People with these negative psychological symptoms have decreased immune system functioning, higher muscle tension, and higher rates of musculoskeletal problems such as fibromyalgia, arthritis, and lower back pain. In some cases, the pain that we experience is a secondary affect to the pain and related disability that is suffered in relation to an orthopedic injury. In other cases, habitual stress and anxiety may have existed before the injury occurred. I either case, patients may experience pain relief by learning and practicing various coping methods for dealing with stress and anxiety.



Stress-Related Back Pain: Stress-related back pain is a condition where pain either originates because of stress and anxiety, or increases the amount of pain that is experienced from a physical injury. The theory that pain may originate as a result of stress, in the absence of a physical injury, is a controversial one. One such doctor who is most responsible for this theory is Dr. John Sarno (MD) of New York. He does not believe that the majority of cases of back pain are caused by obesity, lumbar herniated discs, or facet joint arthritis. He proposes an alternative theory, known as Tension Myositis Syndrome" (TMS) which states most of us experience physical back pain that originates as psychological factor, such as depression, stress, anxiety, or anger. TMS, Sarno believes, is the most common cause of pain as related as related symptoms such as numbness, tingling, muscle weakness, stiffness, and burning pain.

Dr. Sarno does not entirely refute the fact that disease and degenerative conditions could be the cause of pain. In fact, he often recommends that patients receive a physical examination as well as well as the collection of radiologic tests (e.g. X-Ray, CT, MRI) firsthand to rule out any serious medical problems. Once any serious problems have been ruled out, a trained doctor should perform hands on examination to look for the presence of 6 tender points in the body. This test is similar to the one performed in diagnostic medicine for fibromyalgia. The six main tender points that are used to diagnose TMS include: two in the lateral upper buttocks, two in the lumbar paraspinal muscles, and two in the upper trapezius muscles. A tender point is a point that becomes painful or sensitive to the touch, such as when a doctor presses down on this area. This test for tender points is a little different than that used to diagnose fibromyalgia, in which the doctor examines for 18 tender points. Dr. Sarno states that this tender point test has nearly 100 percent accuracy in diagnosing TMS. Treatment protocols to help TMS patients include:
  1. Education
  2. Writing about emotional issues
  3. Resumption of a normal lifestyle
  4. Support meetings
  5. Psychotherapy
The TMS protocol is still relatively new, and the majority of doctors don't support it. Regardless, one of the most recent studies authored by the Seligman Medical Institute (SMI) states that approximately 57% of chronic back pain patients who followed the TMS protocol experienced significant and lasting pain relief.

Stress and Back Bain: Stress and back pain are closely-related human factors that are tied together because of the mind-body connection. The mind-body connection theories have been proposed by physicians of eastern and western medicine, and by philosophers through though the ages. The basic concept is this: that the way we experience the world psychologically affects our physical bodies. We do know that negative psychological factors such as stress and anxiety increase muscle tension. This muscle tension may build up to the point of spasm, or it may causes lower levels of muscle tension that aren't as easily diagnosable but nevertheless cause us to be in pain.