Back pain is a common problem that can have a variety of causes. A reductionist approach which may have been taken in the past may have isolated one specific aspect of an individual (or their life) and blamed that for the resultant back pain. Examples of such causes might have been: a bad night’s sleep, an uncomfortable chair, poor posture, heavy lifting, spending a whole day on your feet, and more. However, medical science is more recently emphasising the importance of the link between mental and physical health. Back pain can factor into this.

In this blog, we will look specifically at whether your back pain could be a result of stress, why this occurs, and how to deal with it.

Can Stress Cause Back Pain?

The short answer is yes, stress can be a significant contributor to back pain. It all depends on your natural response to stress. While some people manifest stress in their minds, running through different problems and potential solutions, others manifest it physically. This physical reaction may be unnoticeable to the individual and the people around them, but it is significant enough to eventually contribute to the experience of pain.

When stress manifests physically it can have a myriad of effects. It can cause headaches, increased muscle tension, fatigue, and gastrointestinal upset. These effects, when prolonged, may result in lower back pain. When there is no exact known cause for your lower back pain, we generally refer to this as ‘non-specific lower back pain’.

Non-specific lower back pain can be a confusing diagnosis for patients, as this insinuates that there is no actual damage present, and your pain is psychological in nature. This is why education is a crucial aspect of any lower back pain diagnosis. Although there may be psychological and social drivers of pain, your pain is very real when it is manifested physically.

A major issue with non-specific lower back pain is that it can easily start off a positive feedback loop, resulting in increased pain. Those who are stressed will feel sore, which affects their mood and makes them less active. This not only impacts their social life, as the reduced physical activity also causes their muscles to weaken and tighten up further, leading to more pain. Additionally, the worry of back pain can result in catastrophising, causing people to become even more stressed, which then results in more pain.

How is this Treated?

Non-specific lower back pain should be treated using a biopsychosocial approach. This model incorporates the biological, psychological and social aspects of pain, as shown in the image below.

Unfortunately, there is no “gold-standard” method for treating individuals with non-specific low back pain, especially when stress is a driving factor.

The biopsychosocial approach is an individualised approach to pain management. Every patient will have different stressors in their lives which may contribute to the development and experience of lower back pain.

Non-specific lower back pain requires a multidisciplinary approach to treatment.

Biological factors – These may be addressed through the physical aspect of treatment. In highly stressed individuals muscle tension can be high, so your physiotherapist may use a variety of soft-tissue techniques to reduce your pain and improve your function. Exercise therapy will also be a key component of treatment. Strength and mobility exercises, as well as breathing work can all be very beneficial to individuals with non-specific lower back pain.
Psychological factors – This will be a key component to address in any individual with high levels of life stressors. Reducing fear-avoidance of painful movements and catastrophising of pain is crucial. Stress management techniques will also be very important to cope with a stressful lifestyle.
Social factors – Social factors may also contribute to pain, with poor job satisfaction being a risk factor for the development of lower back pain. Other factors which may contribute to pain here include low economic status and poor familial support.

Sometimes it can be hard to believe that we are experiencing physical pain as a result of something psychological like stress, but it is a documented scientific fact. You may be tempted to ignore it and just get on with your day, but doing so will likely lead to further long-term problems. Like all medical issues, stress-related back pain is most effectively addressed by getting to the root cause of the problem, so if you have been experiencing consistent pain, don’t ignore it. Visit your physiotherapist and you can start work on getting rid of that pain immediately.

Don't have a physiotherapist? Get in touch with us or visit our back pain treatment section for further advice on how we can help.