Back Pain and Depression – the Chicken and the Egg

From Consumer Reports, June 2017:  Pain may stem from a physical cause, “But it’s perceived in the brain,” says Robert Kerns, Ph.D., a professor at Yale University. …  “That means that pain can amplify-or even cause- depression and anxiety, and vice versa.“

Clients often ask me to tell them how serious is their muscle dysfunction or tension.  I say that what you feel is more important than what I feel.  To understand your pain and/or anxiety and depression, it helps to look at your whole experience.

We tend to look first for a accident or activity that may have caused pain.  But there are many other questions to ask:  How is your sleep? Your diet?  What kind of stresses are you under?  How are you taking care of yourself? All of these factors affect how painful you experience your muscle tension. Serious, even disabling pain may have a primary cause that is not physical.

Massage therapy can help whether the anxiety and stress caused the pain, or the pain caused the anxiety.

Causes and Prevention of Back Pain

The June 2017 issue of Consumer Reports featured a comprehensive  look at the causes and treatments of back pain.

The 5 most common causes:

1)  Muscle Injuries:    cause one third of all back pain

2)  Degenerative Disc changes.  This is a normal part of aging, but often does NOT cause pain

3)  Bulging or slipped discs. May cause sciatica.

4)  Spinal Stenosis.  Thickening of bones or ligaments can irritate nerves

5)  Spinal Instability

Strong and healthy core muscles play a big part in preventing and recovering from back pain.  Almost everyone tweaks, sprains, or injures their back at some point in their life.  Stay ahead of the game by getting regular massage and doing core strengthening exercises.

If you do have sudden severe low back pain, it is often a strain of the Quadratus Lumborum muscle. Massage and patience are two keys to surviving the acute stage of this injury.

Options for core strengthening include yoga, physical therapy, swimming, and strength training.  In general, avoid the circuit weight machines because they support your core. You miss the opportunity to balance your whole body.  In worst cases they can lead to exaggerated muscle imbalances.

One of my favorite sources for excellent whole body workouts including beginner and advanced difficulty is Jessica Smith TV.  She has many free videos on YouTube, as well as programs to purchase.

Causes of back pain

The June 2017 issue of Consumer Reports features a comprehensive look at the causes and treatments of back pain.

The 5 most common causes:

  • Muscle Injuries: one third of all back pain stems from these. Massage therapy and back exercises offer excellent treatment and prevention.
  • Degenerative Disc changes. This is a normal part of aging, and often does NOT cause pain
  • Bulging or slipped discs. Lifting something heavy, especially while twisting or bending, can cause discs to slip or bulge.  This may cause sciatic pain.  The symptoms may persist but they often resolve with therapy and good body mechanics while sitting and while lifting.
  • Spinal Stenosis. With aging, a thickening of bones or ligaments can irritate nerves. Walking makes symptoms worse, while sitting leaning forward may ease them.
  • Spinal Instability. Weak back muscles are unable to support the spine as degenerative changes occur.  A vertebrae sliding forward is called spondylolisthesis, causing sudden pain and weakness.

Keeping your back strong and using good form in sitting, standing, lifting are key.  My next article will discuss exercises and recommend some good local physical therapists.

back injuires

Relief from Back Pain: What studies & surveys say. Part 1: Alternative Therapies

Consumer Reports, June 2017 has a multi-section report on Back Pain including:

  • When to say “no” to surgery
  • New evidence about alternative treatments
  • Ways to keep your back healthy

I will summarize the article, starting with the survey of readers on what techniques of health care providers offered the most help with back pain. The results of this survey are very similar to one that they conducted about 20 years ago. The top four practitioners that were helpful for back pain:

  • 89% Yoga or Tai Chi
  • 84% Massage Therapist
  • 83% Chiropractor
  • 75% Physical Therapist

More than one in four survey respondents said that back pain had severely interfered with their daily life.

So it is very good news that hands-on and other non-drug measures are very effective and much safer than drugs and surgery. Look for a therapist who is experienced and knowledgeable about the anatomy and how different muscles and injuries affect your pain, and will help you understand proactive steps to take (including yoga, see above!)  This quotation from the article is much like what I’ve often said to clients:

“Over the long term, massage makes you more aware of your body and causes you to notice how the way you sit or stand can be contributing to your back pain.”  – Martha Menard, Ph.D.