Chiropractors specialise in conditions related to nerves, muscles, joints, spine, and pelvis, so conditions related to stress are complaints that we encounter in our offices every day. Why is it that stress can have this effect on our body? What is the link between stress and our headache or back pain and most importantly, what can we do about it?
Stress can be a common contributing factor to:
- Low back pain
- Neck pain
- Shoulder pain
- Upper back pain
- Hip and pelvic pain
- Chest pain
- Numbness and tingling
- Jaw pain
- Low energy
- and other common complaints related to our joints, muscles, nerves, ligaments and other soft tissues in our body.
Stress has a variety of effects on the systems of the body. It can effect the:
- Nervous (firing of sympathetic nerves),
- Musculoskeletal (tense, tense),
- Respiratory (increases breathing rate),
- Endocrine (release of stress hormones such as cortisol),
- Gastrointestinal (slows digestion or speeds up the passage of food without nutrients being absorbed properly)
- Reproductive systems (reduced sex drive).
As a Chiropractor, the areas that we primarily encounter the results of stress are its impact on our muscular and nervous systems. We may see people with headaches, jaw pain and clenching, neck and upper back ache, low back pain, hip/pelvic pain, muscle spasming, and numbness or tingling to name a few.
Our nervous system consists of our brain, spinal cord and all the branching nerves from the spinal cord. Our nerves and spinal cord are used to transmit messages from our head (brain) to all our muscles, organs and cells of the body and tell them what to do.
When we are stressed our brain stimulates certain nerves in our body (sympathetic nervous system) which cause a specific stress response. This response used to be very important when we needed to escape from a predator, as we needed our muscles to tighten, our breathing rate to increase and all of our energy going towards preparing to escape rather than digesting our food or thinking about sex.
So the fact that our muscles would tighten up and prepare for action was a good thing. However, many of the stressors of today are not one time "events," but can be long standing conditions that can last for days, weeks or years.
When you run away from a bear that is chasing you, eventually you get away (hopefully) and you can rest and your nervous system can restore things back to the way that it used to be before stress.
However, that work stress that you experience or the stress that you have from dealing with the multiple demands in your life are not something that you can run away from and then relax.
Those stressors may have been there for awhile and they may no go away any time soon, so those stress responses in the body become continuous and that is when problems can arise and our body can break down.
Stress breeds stress
One of the problems with stress is that stress can lead to more stress. For instance, when we are stressed and we are in pain it can often affect our ability to enjoy our day or get a good night sleep. When we do things that we enjoy we feel good. When we sleep, our bodies rest and recover.
If we are not getting time to enjoy our daily activities and rest, it can often make it harder for our bodies to heal and feel better. As a result, we may end up feeling tired and irritable. We may have trouble concentrating and getting through the day.
This can lead to conflict as we may have less patience, less focus, and are more easily upset. As a result, we may end up in conflict with people at home or our coworkers, which in turn can lead to more stress and pain and the cycle continues.
Pain breeds more pain
The other issue is that pain can lead to more pain. When we are in pain ie. Our neck hurts, we may find that our movement is more “guarded.” Instead of turning our head to check our blind spot while driving for example, we may turn our whole body.
Because we are not using our muscles and joints properly, this can lead to more tightness, spasming and inflammation. Next thing we know, our upper back and shoulders start to feel stiff and sore and we cannot move as freely as we once did.
We find that we cannot turn our head as easily or as far as we used to. When our movement is lacking, joints are not moving through their entire range of motion and muscles are tight, those structures can often become weak as they are not being used optimally.
Weakness further restricts normal function and often people can become frustrated, angry or feel helpless.
All these emotions can lead to more stress and ultimately more pain and the cycle continues.
So how do we treat stress and what do we do if our stress is likely to be longstanding?
First of all, of course we want to look at what is causing the stress and find out if there are ways that the stress can be reduced. Usually, by the time the person presents in our office, they have already tried to identify their stresses and do something about it.
However, sometimes we cannot simply remove the stress ie. we cannot just quit our stressful job because we need the income.
In those cases, we look at ways to change our reaction to stress. Sometimes that involves inserting activites in our day that allow us to deal with stress better such as exercise, meditation etc. Once again, most of the time when a patient comes into our office, they have already tried some of those strategies.
So, often where Chiropractor treatment can be very beneficial is helping the person to improve their ability to cope with the stress. For example, if we can get rid of some of the neck pain and headaches and allow the person to get a more comfortable night sleep, concentrate and focus, it can help them to cope with their day much easier.
Also, it is very fatiguing to be in pain, stiff and sore, so if we can address the issues that are causing the discomfort, it can go a long way to helping the person cope with their stress.
Chiropractic treatment can also help to prevent the stress from escalating to the point where they cannot cope and become overwhelmed by their stress, pain and discomfort which only increases their stress.
It is important to realize that sometimes the effects of stress on our body can remain long after the stressor is gone. Sometimes we see people who have just gone through a stressful time, the event or circumstances that caused the stress are now gone but the musculoskeletal issues that developed during the stressful time remain.
Tight, contracted and weak muscles cannot loosen and irritated and stiff joints are still present.
So what can we do to help us deal with some of these issues that develop as a response to stress?
Let’s keep with our example of headaches and tension into the neck and upper back. Often people will present to our office with pain and stiffness in their neck. They may complain of a “bandlike” headache that goes around their head and behind their eyes.
Their neck and upper back may be stiff and tense and they may report that they have trouble turning their head. We would do a comprehensive history to find out about their current complaints, past conditions, what their bodies do all day, sleep patterns, medications, aggravating and relieving factors, other concerns that they may be experiencing and so much more.
This allows us to get a complete picture of the person and their problem. Then based on the results of our history, we would structure an examination to access what structures might be causing the problem.
We might test how much motion they have as they move their head, or we may look at their nerve responses to various tests. We might investigate areas of muscular imbalances, tension or weakness.
Based on the results of the tests and history, we would then recommend a treatment approach and that may include muscular/soft tissue work, gentle mobilizations to improve joint movement, specific and structured exercise and stretching, dry needling/acupuncture, physiotherapy modalities such as ultrasound or referral for additional testing or to a different health professional if warranted.
The important piece of advice to remember is that during times of stress, take time to take care of you. So often in our office we will see people who say, "I have been in so much pain, I have not been sleeping and I have been so stressed, but I did not want to come in until (the stressful event) was over because I did not want to undo all the work that you would do."
So instead they suffer through the stress and seek treatment only when they absolutely cannot cope anymore or after their perceived stress is over.
Often times, it is more work to help them to deal with the consequences of their stress at that time than it would be if they sought treatment when they first started to encounter the discomforts associated with stress.
Also, earlier intervention prevents the stress from becoming a larger issue. If they can minimize their discomfort at the earlier stages, it helps them to deal with their stress and ultimately overcome it.
There are so many resources out there to help you to deal with your stress, you really do not need to suffer.
Dr. Alison Leitch is a Doctor of Chiropractic and Medical Acupuncturist who practices in Noosa on the Sunshine Coast.