Pain like that in the lower back pain can creep up at the worst times in life. Maybe you’re stressed at work or are dealing with a family crisis, and suddenly your back goes out. It might sound strange, but you don’t necessarily need to be injured to feel pain. Sometimes stress can manifest as nagging or debilitating pain.
Chances are you’ll deal with lower back pain at some point in your life. According to the National Institute of Neurological Disorders and Stroke (NINDS), roughly 80% of adults experience it at least once in their lifetime. It’s the leading cause of job disability worldwide, which makes it one of the costliest medical problems.
There are three types of pain: acute, subacute and chronic.
- Acute: Most people experience acute pain, which can last as little as a few days or as much as a few weeks. Everyone starts with acute back pain, but up to 20% of people won’t be able to get rid of it.
- Subacute is pain lasting 4–12 weeks, and
- Chronic pain lasts longer than 12 weeks according to the NINDS. Those who develop chronic pain can be so limited that they stop exercising and develop other medical problems like depression.
It’s important to heal your lower back malady as soon as you can, to avoid slipping into chronic pain.
There are a few types of lower back injuries that can lead to pain. Some occur when you’re doing an activity like lifting weights. Even something as benign as tying a shoe or sneezing can cause a lower back injury. Traumatic events like a car crash or contact sports injury are also possible causes.
- Sprains and strains are injuries to the tendons and ligaments that attach to your spine and the surrounding muscles.
- Herniated discs are injuries to the gel-like discs that sit between vertebrae and act as cushions. Pressure on one side of the disc can cause it to rupture, and press out, potentially hitting a nerve.
- The bones of the vertebrae can fracture, and there are a few types of breaks. Stress fractures tend to be smaller and are caused by repeated stress, such as running. Traumatic events like a car crash can cause bigger breaks of the vertebrae that may even require surgery.
Life stress, such as relationship trouble or pressure from your job, can cause or exacerbate back pain. Todd Sinett, a New York City-based chiropractor, explains that stress can cause myriad problems such as digestive trouble, headaches and back pain. Stress makes your back muscles tighten up, says Sinett.
Lower back pain isn’t as simple as an injury like a cut. When you get cut, the wound hurts, then it heals and stops hurting. Lower back pain can linger — and the symptoms can be remarkably different. Two people can herniate their discs in the same way, and feel completely different amounts of pain. One might be fine and continue life as normal and the other may not be able to work.
That’s why a more comprehensive model was created, called the biopsychosocial model. It takes three components into account: first, the biological part, which is the physical injury. It also considers the psychological part — how you perceive the injury and how you react to it. This is the part of the model that deals with stress, as well as other factors like whether you have a positive or negative outlook.
Finally, the social part has more to do with your ability to recover — not your social network of friends or family. Health insurance that pays for time away from work and your rehabilitation costs makes it much easier to recover and move on from the pain. All these factors make up the biopsychosocial model.
While the social part of the biopsychosocial model is hard to fix, there are various ways to tackle the psychological component. First, you should understand how pain affects the brain.
Pain receptors in your lower back send signals up to various parts of your brain. They tell the brain something bad is happening. In chronic pain, these signals are sent constantly. Your brain then decides how much pain you should feel and when you should feel it.
The more you feel pain, the more sensitive you become, according to an April 2018 study published in the International Journal of Environmental Research and Public Health. The researchers found there are physical changes to areas of the brain that process pain, including those that regulate anxiety.
If you constantly feel pain in your lower back, your brain becomes more sensitive to pain. The pain you feel stresses you out and can affect your sleep, both of which can cause more pain. This is called a positive feedback loop, where two things feed into each other and the problem continually gets worse.
The psychological part of the biopsychosocial model is perhaps the hardest to treat. The above paper recommends relaxation therapy to treat lower back pain. When you’re in pain you’re more likely to fear movements that hurt, and your body tenses up in response. The problem is that exercise is part of the recovery process. In fact, the researchers showed exercise can fight the changes in the brain that lead to chronic pain and help you recover.
READ MORE > HOW TO TRIGGER YOUR STRESS RESPONSE LESS
To move past pain, you need to decrease the fear, anxiety, and stress surrounding your injury. To start, you might want to consider treating the mind first. Two types of therapy produce modest results in treating back pain, according to a March 2016 study published in the Journal of the American Medical Association.
The researchers compared mindfulness-based therapy with cognitive behavioral therapy. They’re similar approaches to treating back pain that focus on relaxation exercises, such as deep breathing, and a shift in mindset. Each treatment was done in a group setting and lasted for roughly two years. Both treatments were similarly effective.
While most rehab programs for the lower back focus on treating the body through stretching and strengthening exercises, few focus on the mind. However, a July 2016 study published in the Journal of Pain found there was no difference between psychological and physical approaches to treatment. This shows how powerful the mind is in the treatment of lower back pain. The researchers concluded that treatment shouldn’t be generalized, and that each person may need some combination of psychological and physical therapy.
In addition to massage or other stress relievers, there are numerous ways to reduce stress. Sinett offers a few exercises and strategies he uses to reduce stress in his patients:
- Deep Breathing
Slowing down your breathing can help you relax. Sit, stand or lie down for this exercise. Breathe in for a count of 4, hold for a count of 4, then breathe out for a count of 4. Repeat this cycle 5 times, and then see how you feel.
- Relaxation Pose
This yoga pose puts your body in a very relaxed state. Lie on your back and scoot up in front of a wall. Extend your legs to 90-degrees so they’re straight up the wall. Your butt should be flat against the wall. Stay in this pose, letting the blood drain out of your legs, and relax.
- Walking/Listening to Music
Go for a nice, calm walk or listen to relaxing music. Both put your mind at ease and help you cope with stress. Repeat as often as needed.
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