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Johns Hopkins Health Alert

How to Cope With Stress - Induced Back Pain

Johns Hopkins Health Alerts | Back Pain - Osteoporosis | How to Cope With Stress - Induced Back Pain

Two studies point to the connection between poor emotional coping skills and back problems.

If you have pain in your back, the source may be inside your head. One of the main causes of back pain is emotional stress, and back pain may be a signal that you are not coping well with stress, according to two new studies.

A recent study of more than 48,000 men in the Swedish Army clearly shows the link between back problems and the ability to cope with stress. These military recruits took a battery of medical examinations, intellectual tests, and a test of their ability to cope with stress. Coping was defined as efforts to manage or modify the negative impact of stress.

The researchers found that more than 5,000 men had a back problem severe enough to interfere with military service. The vast majority of these problems were nonspecific back pain and disease. Those who had poor coping skills were more likely to have back pain. Interestingly, good coping ability and intelligence were strongly associated, which may mean that the smarter you are, the easier it is to learn how to handle stress.

In a similar study, a group of 368 U.S. Army soldiers filled out questionnaires about their health and work habits at their first visit to a clinic for acute low back pain. Job stress was related to emotional distress, and this distress was directly related to clinic visits for back pain. The more emotional distress a soldier had, the more return visits to the clinic it took to solve the back pain.

This study confirms other research that shows the combination of psychological distress and the physiological demands of work relate to increased risk of back symptoms. The Army researchers believe that job stress plays an important role in persistent low back pain, and that reducing emotional distress can reduce that pain.

What’s the Connection? It’s common knowledge that people under stress are tense, and that tension can easily settle in your back. If you experience constant stress, even at a low level, your muscles may be tightening up so often that you don't notice anything out of the ordinary. But those taut muscles can send a strong signal of pain to your brain. The pain may lead you to become leery of doing normal activities. Limiting your movement and activity only leads muscles to become deconditioned and weaker, which in turn leads to more back pain. This sets up a vicious cycle that may end up in chronic back pain.

Johns Hopkins Health Alerts | Back Pain - Osteoporosis | How to Cope With Stress - Induced Back Pain

Posted in Back Pain and Osteoporosis on September 28, 2007
Reviewed June 2008

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Users and editors may post comments here at their own discretion. The views expressed do not constitute medical advice and do not represent the position of Johns Hopkins Medicine or University Health Publishing, which has no responsibility for its content.


Readers my also be interested in a recent published peer reviewed study by the California-based Seligman Medical Institute. According to researchers it may be possible to relieve chronic back pain by simply reeducating sufferers about the physical and emotional origins of their pain. The SMI study, which was just published in the Sept/Oct 2007 issue of Alternative Therapies in Health and Medicine (www.alternative-therapies.com ), suggests that chronic back pain patients can often be effectively treated without surgery, medication or even physical therapy. Using a program consisting solely of office visits, reading assignments, a structured workbook (guided journal), educational audio-CDs, and, in some cases, individual psychotherapy, the study's Principal Investigator David Schechter, MD was able to reduce pain levels of 51 chronic back pain patients (average nine years of pain before treatment) by over 50%.

The title of the article is "Outcomes of a Mind-Body Treament Program for Chronic Back Pain With No Distinct Structural Pathology: A Case Series of Patients Diagnosed and Treated as Tension Myositis Syndrome"

Copies can be obtained via e-mail at: art@robinart.net

Posted by: SMI | September 29, 2007

As a back pain sufferer I'm extremely disappointed to read this article and study. It seems to me it's the old "which came first, the chicken or the egg?" scenario. Do the researches consider that their results may, in fact, be backwards? That back pain causes emotional stress and one to cope inefficiently as opposed to the other way around? Everything cited in their examples could easily be the other way around.

It goes without saying, really, that stress increases pain as stress increases muscle tension, but even during the best of times and most stress free I have been 'layed up' with incredible pain.

It is difficult enough in some cases to find the cause of back pain, for me it took almost 4 years but there is indeed a cause. If all my doctors had read this article I fear they never would have continued trying to find the problem - it would have been chalked up to "all in my head."

It's always a worrisome thing when medical experts relegate to the mind things that don't readily show a visible cause.

Posted by: SheilaGS | October 3, 2007

To: extremely disappointed

Please take a look at www.tmshelp.com

The study in now way is saying that the pain is in your head.

Posted by: SMI | October 3, 2007



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