Introduction

Intro:  Back pain is so prevalent in America and in the world that it’s economically irresponsible not to address it.  It costs the United States $685 billion each year. Eight out of ten Americans will experience back pain in their lifetime. Five percent will develop chronic back pain. I fall into both of those categories. The nervous system causes the fascia to grip and bear down on the muscles surrounding the spine, resulting in chronic pain.  This damage may be caused by impact from sports-related injuries, car accidents, or slip and falls. Spending a long amount of time sitting or standing for work can also create back problems because muscles are chronically gripping. In any case, once the damage has occurred, continuous psychological stress will increase and perpetuate pain. In fact, ongoing psychological stress results in systemic tension throughout the entire body, often causing back and neck pain.   

In this blog, we’ll discuss:

• How Chronic Stress Can Cause and Exacerbate Chronic Back Pain

1. What You Can Do About It (Non-medical Solutions)

How Chronic Stress Can Cause and Exacerbates Chronic Back Pain

It’s important to identify the state of the spine prior to the presence of chronic stress.  Is there some sort of structural damage present that would allow even some inflammation to be an irritant or painful?  When considering instances that are considered acute impact trauma, the spine is almost always compressed as a result.  At the very least the nervous system is hyperactivated or upregulated.  Things like car accidents, sports injuries, slip and falls would be considered acute impact trauma.  

Likewise, the spine could be affected by an idiopathic injury.  An idiopathic injury is brought on with time and compression; no acute impact causes any spinal injury. Rather, over time, from the result of poor posture or gripping, there is now a bulging or herniated disc, and possibly spinal stenosis.  

Regardless of the root cause, there is less space between the discs, and/or the spinal cord has less space.  Actual damage being present and visible by way of imaging aside, people can and do experience chronic back pain. This will be our main focus and topic for this blog, and I’ll get right to the point.

Individuals presenting with chronic back pain without visible damage to the spine are not merely imagining the pain.  Where’s the pain coming from then?   

Chronic stress often results in inflammation of the nervous system.  Whether the source of stress is psychological, nutritional, or structural, the end result is inflammation.  When we are under stress chronically, the body is perpetually releasing pro-inflammatory cytokines.  Cytokines are released as a response from the immune cells.  

This would be all well and good, and tremendously beneficial in acute circumstances.  It aids in the protection of cells and facilitates blood flow and recovery.  It’s the chronic release that makes this helpful response harmful.  

In most instances, there is more than one root cause of the inflammation in the nervous system.  More than likely, it’s caused by two out of three, if not all three of the following: 

• An unhealthy gut microbiome - not enough of the right food, too much of the wrong food.
• Stiffness, trigger points, neuromuscular-skeletal pain, tightness, or poor postural strategy (using large superficial muscles to sit or stand).
• Some sort of emotionally or mentally taxing environment: an abusive relationship, toxic work environment, child or spouse drug addiction.

These are the three pillars of stress we humans are chronically impacted by: nutritional, structural, and psychological.  When two or more of these things are present in a person's experience, inflammation abounds, wreaking havoc on the body - the nervous system included - causing a lot of pain.  The majority of known inflammatory mediators cause pain by binding to their receptors on nociceptive primary sensory neurons in the peripheral nervous system (PNS)  that supply injured skin, muscle, and joint tissues with nerves. 

It’s no wonder inflammation caused by multiple sources of stress results in the likelihood of chronic pain.  But keep in mind, just because someone is experiencing chronic back pain, doesn’t mean there’s something orthopedically wrong.  However, if there is in fact an orthopedic issue present, the chronic stress will certainly make the experience far worse. 

What You Can Do About It

Let me first say that in some cases in which there is in fact structural damage beyond a certain point, surgical intervention may be required.

Now that I got that out of the way - let’s talk about what you can immediately begin to do on your own to reduce inflammation in the body and in the nervous system.  We’ll stick with the three pillars of stress mentioned above: nutritional, structural, and psychological.  Within each, there are things that are completely out of your control, and although important to make mention of, it’s not what we’re here to discuss. There are actions within each pillar that you can begin taking immediately to reduce inflammation within the body and nervous system.

Nutrition

Think of food as information for the body.  The body responds specifically to what is in the food.   Food can signal the release of stress hormones into the gut and bloodstream, resulting in inflammation.  If you’re being burned by a hot iron, causing pain and inflammation to your skin, the first and best piece of advice is to remove the hot iron.  The same is true with food; the first and best piece of advice is to remove what’s causing the problem.  

Almost always, it’s removing one or all of the following: sugar, alcohol, or dairy.  These all negatively affect the gut, brain, nervous, respiratory, and fascial systems, causing inflammation, pain, and discomfort.  

Certainly, not all sugar is created equally, and I’m not suggesting you remove fruits or vegetables from your diet.  It’s the processed, refined sugar that’s the culprit.  Likewise, some dairy infrequently is ok and good for the body.  

Out with the bad and in with the good, as they say.  You want to begin taking in more foods that are anti-inflammatory in nature, balance out the gut and are rich in vitamins and minerals.  Primarily your diet should include extra-virgin olive oil, garlic, bell peppers, mushrooms, leafy greens, citrus fruits, and berries.  These, along with an increase in water intake, will begin to move all systems in the right direction.  Keep in mind that just as the peak of inflammation didn’t happen overnight, in the same way, the undoing of its effects will slowly subside.  

Tip 1: Hydration and Sleep

However, if the nervous system is inflamed, two things can have the most immediate impact; hydration and sleep.  Quality sleep in and of itself is anti-inflammatory.  The nervous system, like all other systems, requires sleep and water to function well.  Getting better sleep and beginning to increase your water intake are vital components of the “in with the good” part of this equation.  

Structural

Structural stress includes tightness, gripping, and pain, from habits like sitting or standing, or from an old injury, or surgery.  Addressing nutritional stress will in fact help alleviate some of the fascial restrictions and pain.  Once the nervous system and fascial system are healthier and well-hydrated, they will certainly feel and function better.  There are several things you can do extrinsically to address structural stress.  

They are categorically called regenerative methods.  Regenerative methods include cold therapy, ice baths, saunas, massages, foam rolling, acupuncture, cupping, instrument-assisted soft tissue massages (IASTM), like Rock Blades, and percussion therapy, such as Hyperice. Many of these things you can do on your own. A combination of these things used well will reduce structural stress, take pressure off of the neuromuscular skeletal system, and provide the relief you need.  

If you’re outsourcing manual therapy of some kind, always keep in mind if the therapy is so painful that you have to clinch up, the pressure is too much.  It should be the amount of pressure you can tolerate in a fully relaxed state. If the nerve isn’t releasing, then the muscle isn’t going to relax.  

Nerves letting go have more to do with what you do intrinsically than extrinsically,  keeping in mind that the nutrition component mentioned above is vital to facilitating the releasing or letting go of a nerve.  

Tip 2: Breathing

Along with that is breathing.  Breathing plays an overwhelmingly powerful role in the relaxation of nerves.  Breathing is responsible for more than just bringing in oxygen.  Done well, it is responsible for increasing vagal tone, regulating the nervous system, mobilizing food through the GI tract, and creating segmental spinal stability.  

This is where breathing can single-handedly reduce back pain - segmental spinal stability.  For almost all back issues, compression is the problem.  Whether from gravity, gripping, posture, exercise, or compressed vertebrae,  various spinal issues result.  The solution? Suspension. But, how do we achieve suspension?  Three-dimensional, diaphragmatic breathing.  It’s the only way to regulate intra-abdominal pressure that results in a degree of suspension within the spine.  To learn more: Book a call.

Psychological

Mental and emotional stress varies in nature from past or current abuse, high-pressured jobs, having too much on your plate, insecurities, losing a loved one, moving, financial struggle, having an unhealthy family member, and the list goes on.

What’s important is to identify what it is that you can control.  If you notice, in the list above, some stressors are uncontrollable, and in that case, there’s little in the way of action that you can take.  

Understanding that it is uncontrollable doesn’t erase the stress it causes, but contributes to some solace, and will allow you to direct whatever energy you do have to the areas where you can make a difference in your life.  

A few things that will help:

• Take medication if it’s advised by a doctor. 
• Seek help when you need it. 
• Control what you can.

Tip 3: Don’t Engage in Destructive Things to Feel Better

Oftentimes, people, (myself included), have resorted to unhealthy, destructive things to “feel better.”  Seeking out superficial dopamine releases through unhealthy, destructive behavior may make us feel better at the moment, but really is only another thing for us to feel bad about.

Takeaway Questions:

• Is there actual structural damage in my spine? 
• Do I have recent X-rays and MRIs indicating so?
• What can I remove from my diet that’s causing inflammation?
• Am I dehydrated and/or lacking sleep?
• How can I implement three-dimensional diaphragmatic breathing into my day?
• What toxic people or behavior do I need to remove from my life?

By: Vinny Nuzzo, mr_stress_undone

Integrative Health Coach