Stress Could Contribute to Low Back Pain

Lower back pain is one of the most common health problems that people across the world complain about. While it is common knowledge that poor posture and today’s sedentary lifestyle are the chief culprits, a specialist neurosurgeon at Burjeel Hospital of Advanced Surgery feels that psychological issues might also have a role to play when it comes to low back pain.

Low back pain is one of the main reasons cited for absenteeism in the workplace. Based on statistics provided by the World Health Organization, the lifetime prevalence of common low back pain is estimated at 60 per cent to 70 cent in industrialized countries. Though this is generally seen in the age group from 30 to 55 years of age, it has become increasingly prevalent in younger people as well.

Dr. Sebouh Z. Kassis, Specialist Neurosurgeon, Burjeel Hospital of Advanced Surgery, and one of most renowned experts in the UAE in the field of spine surgery, said that low back pain can be attributed to a number of factors that can range from injuries to the back, muscle strain, poor posture, sedentary lifestyle and obesity. He said psychological issues stemming from stress and anxiety may possibly make the issue worse. He said that those who regularly lift heavy weights as part of their jobs like those involved in construction or those who have to stand for long hours at the workplace and pregnant women are at a higher risk of lower back pain. When it comes to the non-specific type, it is often difficult to trace the root cause of the pain.”

He added that those who have non-specific back pain could have mild to severe symptoms with lower back pain which can also spread to the buttocks or upper part of the thighs. This kind of pain does not spread down to the foot and is not associated with abnormal feelings in the legs such as numbness, tingling sensation or pins and needles.

Normally, a doctor would conduct a physical examination to check for the site of the pain, if there is a muscle spasm and confirm if the pain is non-specific in nature. Sometimes, a more detailed evaluation using an x-ray and MRI may be required based on the severity of the pain and the presence other symptoms to determine the cause. When it comes to non-specific back pain, these exams may not show abnormal findings in the spine most of the time.

Sometimes the pain is caused by twisting awkwardly, or sleeping in an uncomfortable position. Stress can also worsen symptoms of pain in the lower back. Dr. Kassis said that stress causes the body to release stress hormones, and these could in turn, cause certain physical, mental and emotional changes that the body feels will enhance its ability to deal with a perceived threat — also called the fight or flight response. These stress hormones cause muscles in the body to tighten and the resultant rigidity and tightness can result in pain in areas such as the neck, shoulders and lower back especially if the person goes through prolonged periods of stress.

Generally, doctors prescribe a short period of rest and medication like muscle relaxants and non-steroidal anti-inflammatory drugs (NSAIDS) for a period of one week to aid recovery. Heat therapy may help to relax the muscles. Physiotherapy including manual therapy, exercises to improve flexibility, correct posture and body mechanics may be needed additionally.

If the pain lasts for over two weeks, worsens or spreads to the legs, or causes numbness or weaknesses in the legs, it is important to see a doctor immediately as this could point to a serious underlying issue like a prolapsed disc, infection or other neurological condition, according to Dr. Kassis.

“Prevention is the key to avoiding lower back pain. The regular practice of exercises that promote muscle flexibility and strength are highly recommended to avoid this. Proper body mechanics are equally important in avoiding injury to the lower back so the right posture and the correct way to lift things or bend can save you a lot of pain and a visit to the doctor. It’s also important to be extra careful before being engaged in active physical exercises if a person has previously suffered from lower back pain, as the chances of injury is higher,” added Dr. Kassis.