Stress and Low Back Pain

There is growing evidence that sleep disturbance, sustained high stress levels, depressed mood and anxiety are all strong predictors of low back pain (Gatchel et al 2007). This is compounded by the presence of significant pain which impacts all areas of life and can alter mood and stress levels.  Seeing a healthcare professional/physiotherapist early in an episode of acute low back pain  can make a big difference as they will be able to identify if these factors play a role in your pain.  There are some questionnaires that can be used to sort out those most at risk and specific treatments can be commenced early on to reduced the risk of chronic low back pain.


If you have noticed that stress and mood affect your pain, or you feel that your pain is not caused by mechanical triggers such as certain movements, activities or postures (“it seems to have a life of its own”) learning to manage your stress and mood may be a particularly important part of managing your low back pain.  Your physiotherapist or healthcare professional can talk to you about different strategies that may be appropriate- these can include exercise, mindfulness and cognitive behavioural therapy.


Negative beliefs about low back pain have been shown to be associated with increasing pain and disability levels as well as increased work absenteeism and chronicity.  You may have picked up such ideas from well meaning friends, work colleagues or even health professionals - things like “your back is permanently damaged and weak”, “you should always avoid bending and lifting”, “your back is worn out” and “always stop if there is any pain”.  It is useful to discuss these thoughts with your physiotherapist/healthcare professional during the interview to explore how they relate to your situation.  It is possible these negative thoughts are actually increasing stress and the sensitisation of your spinal structures.  These negative beliefs can prevent you from engaging in activities that we know are useful in the management of low back pain such as exercise and returning to work and social life.


There is also growing evidence that our ‘modern’ lifestyle may contribute to the sensitisation of spinal structures - smoking, poor nutrition, alcohol and lack of exercise may all have a role to play in LBP.  Making improvements in these areas may have a positive impact on your pain.