How Stress Can Cause Back (and Neck) Pain

Stress is a part of life, and so is back pain. Ironically, stress is a leading cause of episodic back pain.

Your body experiences a cascade of physiological responses during chronic stress setting the stage for injury. The human body is genetically programmed to respond to stressful situations by stimulation in a survival part of your brain known as the limbic system. Otherwise known as the reptilian or primal brain, it is responsible for the emotional "flight or fight" (run or stand and fight) response to negative stimuli.

 Your brain response functions the same in stressful situations regardless of the source and extent of the threatening stimuli. The limbic brain does not recognize differences between types and degrees of stress. It simply reacts. Your body releases hormones (chemical messengers) which cause a physical reaction to stress; shortness of breath, sweating, increased heart rate, muscle tension, tightness or stiffness in joints, etc., in preparation for survival reaction.

So whether you are about to be chased by a rabid dog, cut off in traffic, or had a tough day at work the same response occurs. The same negative physical impact also occurs on the body.

 There are several different types of stress and learning how to control them can make all the difference. You have physical stress (lack of exercise, illness, sleep habits, etc), mental stress (how you deal emotionally with life) and chemical stress (nutritional and environmental).

Stress alters breathing patterns by causing you to breathe more from the chest/lungs than the diaphragm. This altered pattern increases tension in the neck and upper back leading to poor posture, muscle tightness and headaches. The diaphragm is a dome shaped muscle that sits in the lower part of the ribcage underneath the lungs. Optimal breathing patterns should occur from the diaphragm first, followed by the lungs. Most often people have dysfunctional patterns where this sequence is reversed.

 Breathing is the foundation for relaxation. Learn to control your breathing and you will have discovered a secret weapon of relaxation and stress reduction. To check your breathing pattern lie on your back with knees bent. Close your eyes and place one hand on your abdomen and the other on your chest. Take a deep breath in through your nose. The lower hand should move first and the upper hand second. If the upper hand moves first you have an altered breathing pattern. Luckily it is fairly easy to learn how to breathe again properly. In our quick tip help guide below you will learn how to restore normal breathing patterns.

Stress increases tension in the body 24/7. It is like flipping the light switch on for self- protection, muscle tension and tightness. Think about how stiff and tight you feel when walking across ice. Your body tenses up in anticipation of falling and is trying to protect you from injury. Imagine how your muscles would feel if you were in this constant state of tension for weeks at a time. It would not feel good! That is what chronic stress is doing.

 Stress increases production of specific hormones known as cortisol and adrenaline located in the adrenal glands. These are two small glands that rest on top of the kidneys, one on either side. Cortisol is nicknamed the "stress hormone" and it can cause many negative reactions in the body if it is unbalanced. Chronically elevated levels of cortisol and adrenaline will cause increased inflammation in the body. In essence, your own body begins to turn on itself.

So what are some simple and effective tips you can start doing today to help alleviate stress? Below are suggestions for helping physical, mental and environmental stress in your life.

Nutrition: Eat healthy and eat often to control blood sugar levels. When you wait long periods between meals, you have a spike of a hormone known as insulin. This hormone controls how fast sugar enters your bloodstream after eating. Big surges in insulin occur when you wait too long between meals which may increase stress on your body chemistry. You can get cravings and mood swings. Eating only three meals a day is insufficient in keeping this delicate balance of hormones in check. It is recommended to eat three meals a day, mixed in with 2-3 healthy snacks. You will notice a renewed sense of energy and vitality with regular feedings.

Mental: Take some "me" time every morning before you start the day. Use this time to reflect on yesterday and plan out today's events. With the craziness of non-stop information overload in today's society it's more important than ever to take quiet moments. Set your alarm 15-minutes early and wake up to silence. Do not turn on the television or open the newspaper. You may find that problems which have plagued you suddenly become more manageable and put into perspective. When was the last time you sat in a room without white noise all around? Try it and see what happens.

Physical: Learning how to breathe with your diaphragm takes some practice, but in time it will become second nature. Practice the following technique on a daily basis for 3-5minutes. Lie on your back, putting a pillow support under your knees to relax your lower back. Place one hand on your abdomen and the other on your chest. Slowly inhale through your nose and make sure the only hand to move is the one on your abdomen. Try to keep the hand on your chest as still as possible. Exhale through pursed lips and repeat. You may become temporarily lightheaded after your first few, but this is a normal response to the increase in oxygen uptake by the body. Do this before bed time and you will have a more restful sleep leading increased recovery and regeneration.

You do have power over your body. Simple changes in your life to help reduce stress can have a profound impact on your health. Take back control of your life from pain. Empower yourself to feel good again mentally and physically. Start with the simple strategies above and when you feel the positive difference you will want more for yourself.

To decrease the stress in your life, talk to your chiropractor about your concerns.

Are You Suffering From the #1 Cause of Worldwide Disability?

Are you suffering from back or neck pain?

 You're definitely not alone, and we mean on a global scale. A series of studies emerging from the Global Burden of Disease 2010 Project, a massive collaboration between the World Health Organization, the Institute for Health Metrics and Evaluation, the University of Queensland School of Population Health, Harvard School of Public Health, Johns Hopkins Bloomberg School of Public Health, and the University of Tokyo, Imperial College London, clarifies the worldwide health burden of musculoskeletal conditions, particularly back and neck pain, in crystal-clear fashion, with low back pain identified as the number-one cause of disability worldwide and neck pain the number-four cause. Overall, musculoskeletal conditions represent the second leading cause of global disability.

Findings emphasize the shift in global health that has resulted from disability making an increasingly larger footprint on the burden of disease compared to a mere 20-30 years ago. In addition, while more people are living longer, the flip side is that they do so with an increasing risk of living with the burden of pain, disability and disease compared to generations past.

Dr. Scott Haldeman, a neurologist and doctor of chiropractic, provides a summary of the project's findings that should make it abundantly clear that conditions many people may consider relatively harmless actually have tremendous potential for long-term health consequences:

• Musculoskeletal conditions such as low back pain, neck pain and arthritis affect more than 1.7 billion people worldwide and have a greater impact on the health of the world population (death and disability) than HIV/AIDS, tropical diseases including malaria, the forces of war and nature, and all neurological conditions combined. 
• When considering death and disability in the health equation, musculoskeletal disorders cause 21.3 percent of all years lived with disability (YLDs), second only to mental and behavioral disorders, which account for 22.7 percent of YLDs.
• Musculoskeletal conditions represent the sixth leading cause of death and disability, with only cardiovascular and circulatory diseases, neonatal diseases, neoplasms, and mental and behavorial disorders accounting for more death and disability worldwide.
• Low back pain is the most dominant musculoskeletal condition, accounting for nearly one-half of all musculoskeletal YLDs. Neck pain accounts for one-fifth of musculoskeletal YLDs.
• Low back pain is the sixth most important contributor to the global disease burden (death and disability), and has a greater impact on global health than malaria, preterm birth complications, COPD, tuberculosis, diabetes or lung cancer.
• When combined with neck pain (21st most important contributor to the global disease burden – death and disability), painful spinal disorders are second only to ischemic heart disease in terms of their impact on the global burden of disease. Spinal disorders have a greater impact than HIV/AIDS, malaria, lower respiratory infections, stroke, breast and lung cancer combined, Alzheimer's disease, diabetes, depression or traffic injuries.
• Current estimates suggest that 632.045 million people worldwide suffer from low back pain and 332.049 million people worldwide suffer from neck pain.

"The Global Burden of Disease Study provides indisputable evidence that musculoskeletal conditions are an enormous and emerging problem in all parts of the world and need to be given the same priority for policy and resources as other major conditions like cancer, mental health and cardiovascular disease," said Dr. Haldeman.

The seven studies from Global Burden of Disease 2010, as well as accompanying commentaries, appear in The Lancet. And by the way, when it comes to preventing and treating musculoskeletal issues, particularly back and neck pain, chiropractic care has been shown in numerous research studies to be an effective conservative option.

How Commuting Effects Your Neck and Back Pain

Unless you're a work-at-home member of the labor force (which has its own health risks, by the way), most of us commute from home to work and back again at least five days a week. From a health perspective, research suggests commuting is bad news, and it goes beyond the stress associated with those bumper-to-bumper, road-rage meltdowns you find yourself experiencing ... but somehow think you can handle day after day, week after week, year after year.
 
According to several recent studies, commuting – particularly longer times spent commuting – has a negative impact on weight, blood pressure, sleep quality / amount and heart disease. One study suggested the longer the commute, the higher the commuter's body-mass index, waist circumference, diastolic and systolic blood pressure, and metabolic risk factors. Another study found that high blood pressure, stress and heart disease were more likely in people who commuted more than 30 miles a day. And in a third study, researchers concluded: "Commuting long distances negatively impacts one's ability to capture adequate sleep."

The Telecommuting Age isn't necessarily solving the commuting health crisis, either; after all, even as more people work from home, the population at large continues to do more driving and less transportation by other means (bikes, foot, etc.). More time in cars, less time exercising - another recipe for health disaster.

The solution, if there is one, is to find ways to make your commutes as short, stress-free and infrequent as possible. Here are a few suggestions:

• Map it out: If there are multiple routes to your job, try some trial and error to determine which one gets you to and from work in the shortest – and least painful – amount of time.
• Try 40 in 4: If your employer / state allows, ask about a possible four-day, 10-hour-a-day workweek option. You'll find that the 10 hours aren't a major drain, and you'll appreciate the extra day away from work – and out of the traffic jams.
• Carpool: Yes, you're still spending time in a car, but at least you aren't always the one driving (and dealing with other drivers); and you're also not alone with your traffic frustrations, all of which contribute to stress.
• Schedule it & stick to it: A likely explanation for why longer commutes lead to higher weight, etc., is not only that commuters sit in a car too long, but also that by the time they get home, they have little time – or perhaps interest – in exercising. Schedule in exercise before or after work and stick to the routine. It will help counter some of the effects of your commute, including stress.

For many people, commuting is a reality, and depending on the job opportunity and living situation, they can't change the distance to and from work. But that doesn't mean you're destined to a life in the slow lane and its debilitating health effects.

DC or MD: What's The Difference For Back Pain?

When you're suffering low back pain, shoulder pain or any number of similar musculoskeletal conditions, who gets the call: your medical doctor or your doctor of chiropractic? Your choice of health care provider in those situations could make a big difference, and research is continuing to prove it. According to the latest study, chiropractic care is at least as effective as medical care for certain musculoskeletal conditions, while reducing health care costs and leaving patients more satisfied with the results.

The authors of the study, published in the Journal of Manipulative and Physiological Therapeutics (JMPT), went so far as to state that for certain musculoskeletal conditions, visiting an MD first instead of a DC may actually be a mistake:

"The findings of this study support first-contact care provided by DCs as an alternative to first-contact care provided by MDs for a select number of musculoskeletal conditions. Restrictive models of care in which patients are required to contact a medical provider before consulting a chiropractic provider may be counterproductive for patients experiencing the musculoskeletal conditions investigated and possibly others."

The study sample included 403 patients who saw medical doctors and 316 patients who saw doctors of chiropractic as the initial health care providers for their spinal, hip or shoulder pain complaint. Four months following care, all patients completed a questionnaire that evaluated pain on that day and four months earlier (11-point scale); satisfaction with care received and the results of that care (5-point scale from "very satisfied" to "very unsatisfied"); and other variables. The researchers evaluated related costs of care by reviewing an insurance claims database.

"Patients initially consulting MDs had significantly less reduction in their numerical pain rating score and were significantly less likely to be satisfied with the care received and the outcome of care." What's more average per-patient costs over the four-month period were significantly lower in patients who initially consulted DCs ($368 difference compared to MD care).

JMPT Editor-in-Chief Claire Johnson, DC, MEd, emphasized the importance of the latest findings: "Comparative studies – in other words, research that compares the outcomes between two different providers or modalities – are rare for chiropractic care," she said. "Thus, this study ... is especially important if payers and policy-makers are to better understand the ‘triple aim' as it relates to chiropractic. Specifically, this study helps us better understand what type of care provides better patient satisfaction, is more cost effective, and improves population health."

The answer, suggests an increasing body of research, is chiropractic care.

How To Help Prevent Back & Neck Pain

Your spine is the backbone of your entire body – literally and figuratively. That means poor spine health can negatively impact you from head to toe. How can you keep your spine in shape? Let's learn more about this critical anatomical structure and take a look at some of the simple strategies you can employ to ensure a healthy spine and a healthy body.

Exercises (to Do and Not to Do):
 Since we're talking shape here, let's start with a few exercises that help promote spinal health in the form of proper posture – along with a few that promote poor posture and put the spine at risk. First, a strong core supports the spine, whereas a weak core can lead to pain and injury. To build the core, think planks, bent-leg knee raises, stability ball exercises, ab curls, medicine ball slams and other exercises that strengthen the core muscles (remembering to keep your spine protected at all times by avoiding rounding the back / neck). On the other hand, avoid exercises / movements that unduly stress the spine: slumping while sitting and bending forward immediately after sitting come to mind, as do exercises that make you prone to rounding your back (traditional sit-ups, toe-touches, etc.).

Sleep Matters:
 Your sleep position and the overall quality of your sleep play a big role in spinal health. The ideal position for the spine during sleep places you on your back with a pillow between your legs. As you might imagine, lying on your stomach is the worse position. Your pillow and mattress also matter, so make sure you choose the right ones for you, or your spine will let you know with neck and/or back pain. (Talk to your chiropractor for suggestions.)

Nutrition Essentials:
 Believe it or not, certain foods promote a healthy spine (and vice versa). For example, adequate water intake is necessary to nourish not only the body's cells, but also the spinal intervertebral discs, which consist primarily of water at birth. As you might imagine, water helps keep the discs (and thus the spine) from getting stiff and subject to injury.  In addition, an anti-inflammatory diet is key to preventing back pain and other spine problems due to inflammation. Think foods such as omega-3 fish and lean proteins, fresh produce, avocado, olive oil, and various spices while reducing intake of pro-inflammatory foods (most fast foods and processed foods, sugar-laden sweets, etc.).

Chiropractic Care:
 No conversation about spine health would be complete without mentioning chiropractic, an entire health care profession founded on the principle that a healthy, properly aligned spine has far-reaching effects on the entire body. Research asserts chiropractic's effectiveness in treating back pain, neck pain and various other musculoskeletal conditions, and the goal of periodic chiropractic care is to maintain spinal health, optimize the body's self-healing capacities, and thus prevent pain from returning. If you haven't been to a chiropractor yet, what are you waiting for? If you've visited one, but haven't returned in awhile, remember: your spine – and your entire body – deserve it.

5 Common Causes of Neck Pain (and How Chiropractic Can Help)

Neck pain can be acute (short term) or chronic (recurring or persisting for months and even years), but regardless, when you're in pain, relief is the first thing on your mind. Just as important as relief, of course, is finding the cause and ensuring you avoid the behavior / action that brought the pain on in the first place. Here are five common causes of neck pain – and why doctors of chiropractic are well-suited to relieve the pain and determine the underlying cause.

1. Poor Posture: Leaning over a desk all day or slouching in your office chair? You're bound to develop neck pain eventually, if you haven't already. Do this quick test: In an upright or seated position, round your shoulders and back (poor posture). Does it impact your neck as well? Exactly!

2. Monitor Madness: Staring at the computer screen for hours at a time? That's not good for your health (or sanity), but from a neck pain perspective, it's madness, particularly if the screen height forces you to crane your neck up (too high) or extend it down (too low).

3. Sleep Issues: Ideally, we spend a third of our day sleeping, so your sleep habits – for better or worse – can have a dramatic effect on your health. With regard to neck pain, anytime you sleep in an uncomfortable position, particularly one that stresses your neck musculature (think about side-sleeping while grabbing your pillow tightly, sleeping on your stomach with your arms out in front of you, or even sleeping on your back, but with a pillow that doesn't adequately support your neck), you risk neck pain.

4. Technology Overload: We may spend a third of our day sleeping, but we increasingly spend the other 16 hours typing, texting, tapping and otherwise interacting with our smartphones, tablets, etc. Bottom line: bad for your neck. One doctor has even coined the phrase, "text neck," to describe the neck pain that can result from this constant technology interaction.

5. The Wrong Movement: Twisting, turning, stretching and stressing your neck is an easy way to cause neck pain. While the muscles in the neck are strong, they can be strained, sprained and even torn, just like any other muscle.

It's important to note that beyond these common causes, various other health issues can also contribute to or directly cause neck pain, including fibromyalgia, cervical arthritis or spondylosis (essentially spinal arthritis), spinal stenosis (narrowing of the spinal canal), infection of the spine, and even cancer. The good news is that a doctor of chiropractic can help identify which of these or the above causes is to blame.

When neck pain strikes, most people turn to a temporary solution first: pain-relieving medication. But that's not a permanent solution, of course, and it doesn't address the cause of the pain at all, which could be something relatively minor – or more serious. What's more, research suggests chiropractic spinal manipulation is actually more effective than over-the-counter and prescription medication for relieving both acute and subacute neck pain.

The Burden of Back Pain: #1 Cause of Disability

More people may be living longer, but they're not enjoying it, particularly when it comes to musculoskeletal health, according to the latest Global Burden of Disease (GBD) study.¹ The largest analysis of global disability data to date, GBD 2013 reveals that "the burden of musculoskeletal disorders [is] much larger than previously appreciated," accounting for nearly 21 percent of global years lived with disability as of 2013.

 Back pain remains the No. 1 cause of years lived with disability worldwide; neck pain is also a common contributor to years lived with disability.

Led by the Institute for Health Metrics and Evaluation and funded by the Bill and Melinda Gates Foundation, GBD 2013 represents a massive analysis of global disability data, with 35,000 data sources spanning 188 countries.² Here are a few of the key findings from the latest analysis, published in Lancet in June, highlighting the global musculoskeletal disability burden

The Musculoskeletal Burden

• "In this analysis, we show that musculoskeletal disorders ranged from 9.6% of YLDs [years living with disability] to 28.9% of YLDs between 188 countries. Low back pain was the leading cause of YLDs in 86 countries and the second or third leading cause in 67 countries."
• "Musculoskeletal disorders combined with fractures and soft tissue injuries reached a total of 20.8% of global YLDs in 2013 ... Our analysis of time trends showed that this category of disorders was an important driver of rising YLD rates per person. Increases were driven by ageing of the population in most countries with trends in obesity and physical inactivity likely exacerbating the problem. Musculoskeletal disorders were not only an important contributor to the burden of disease but were also a crucial component of health expenditure in many high-income and middle-income countries."

Nonmusculoskeletal Burden
While back pain maintains the No. 1 position in terms of its impact on years living with disability, diabetes now occupies the No. 7 spot, moving up three positions from 1990 to 2013. In the U.S. alone, diabetes prevalence increased 71 percent over that time period.² What's more, almost a quarter of the global population suffers from tension headaches, while one in eight suffers migraines.³

From Analysis to Action?
Will data drive health-care decision-making? Comments by the GBD 2013 collaborators and other health policy experts suggest something has to give:
The GBD 2013 authors emphasize, "Although the GBD 2010 analysis brought more attention to these disorders, there remains little policy discussion of the options available to prevent and address these disorders."¹

Rifat Atun, professor of global health systems and director of the Global Health Systems Cluster at Harvard University's T.H. Chan School of Public Health, authored a commentary to the latest Lancet report and urges adoption of a prevention and wellness model to as a vital step to address the chronic disease burden:
"Don't wait for illness, invest in the maintenance of health," he said. "We can't manage these chronic conditions in hospitals, so there needs to be an emphasis on maintaining good health, preventing disease and slowing progression of disease when it does happen. There's no choice; it has to happen."⁴

If you're interested in reviewing the complete report, GBD 2013 provides the latest trends in disease and injury incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries – but be prepared. Reporter John Ross perhaps sums up the grim findings best:
"A focus on cheating death rather than keeping people healthy has transformed the planet's population into a world of walking wounded, a massive inventory of global illness levels has found. ... Premature death rates are in decline. But the death toll has been replaced by a colossal disability burden, with hundreds of millions of years of productive life lost each year to pain and disease."⁵

Are you suffering back or other pain that's reducing your quality of life? If so, you're obviously not alone. Fortunately, doctors of chiropractic can help relieve your back pain – and help prevent its return – in addition to managing a host of other musculoskeletal and nonmusculoskeletal health issues without drugs or surgery.
References

1. Vos T, Barber RM, Bell B, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet, epub ahead of print June 8, 2015.
2. Tavernise S. "Global Diabetes Rates Are Rising as Obesity Spreads." New York Times, June 8, 2015.
3. Macrae F. "Back Pain Is the Biggest Cause of Ill Health in the World: Issues Cause More "Years Lived With Disability" Than Any Other Condition." Daily Mail, June 8, 2015.
4. Coghlan A. "Defying Death Is Causing Back Pain, Bad Teeth and Depression." New Scientist, June 8, 2015.
5. Ross J. "Illness Study a 'Call to Arms.'" The Australian, June 9, 2015.