Stress is a quantifiable and qualitative feeling of mental and/or physical tension. Causes of stress and stress symptoms were previously discussed in our post “A Closer Look at Stress: Impacts on the Human Body”

Can Muscle Pain Be Stress Related?

Chronic pain is a pressing and debilitating issue that reduces productivity and contributes to high healthcare costs, with more than 20% of U.S Citizens affected in 2016. Chronic pain also encompasses tiredness, being exhausted, and general fatigue which are all conditions holding us back from peak performance. Research has shown that a significant portion of individuals afflicted with chronic pain have overlapping psychiatric disorders; in a 2005 study performed by UW, Harvard, and UNC Researchers, >68% of participants from a sample size of ~5700 chronic spinal pain patients had some other pain condition, and 35% had coexisting mental condition. It was concluded that this coexisting pain and mental disorder was significantly involved in the fatigue and musculoskeletal system issues associated with chronic spinal pain.

Another study with a cohort of 422 adolescent patients found that there were significant associations between various factors of stress and pain; higher levels of stress (such as worries, tension, lack of happiness) correlated with longer pain duration, a greater number of pain sites, and increased pain intensity. Similar correlations have also been found in instances where individuals have symptoms of both fatigue and chronic pain.

This leads to the belief that stress can manifest as pain within the musculoskeletal system. It is important to make the distinction that some psychiatric diagnoses have genetic or biochemical roots that cannot be discerned during an initial consultation/diagnosis. 

So Explain This Further

Psychiatric disorders and musculoskeletal disorders both stem from neurobiological pathophysiologies, and have shared mechanisms of symptoms at the molecular level. It’s been found that the motor component of pain, that shows up in our musculoskeletal systems, shares neuronal circuitry with stress signaling pathways; both stress and pain signals are integrated in the hippocampus, amygdala, and ventromedial prefrontal cortex, with indications of physicochemical remodeling in chronic disordered states.

A linked model, such as the one described earlier, is gaining popularity and prevalence. In the future, you could expect a medical diagnosis of a musculoskeletal system symptom such as neck and shoulder pain or chronic back pain to have some type of psychological or stress component to it. 

You Still Didn’t Answer “How Does Stress Affect Your Musculoskeletal System?”

Long story short, psychiatric disorders and issues with the musculoskeletal system go hand-in-hand. If you are getting easily tired, are always exhausted, and deal with much more fatigue than you want even though you live a fairly active lifestyle, it’s likely there are some mental factors or other stressors that must be dealt with. No amount of hip stretches, back stretches, or neck stretches, can compensate for unaddressed stressors. 

In most cases, stress worsens preexisting issues of the musculoskeletal system (such as tension and fatigue). Additionally, researchers believe that pain in the musculoskeletal system can be experienced without tissue damage or some molecular change, and is regulated by cognitive processes.

I’VE HAD ENOUGH…I DON’T WANT STRESS, FATIGUE OR ISSUES WITH MY MUSCULOSKELETAL SYSTEM. WHAT DO I DO?

You can try to reduce the number of stressors in your life. The clear cut answer is to move away to a cabin in the mountain to live the rest of your days, off the grid, with a reclusive and self-sufficient lifestyle. Kidding. Just partially. 

It’s important to lessen (and possibly remove) the stressors in your work environment or home through a combination of methods so you can achieve optimal well being and peak performance

To reduce the damage from lifestyle induced disorders of the musculoskeletal system, such as lower back pain and ankle pain, it’s important to have healthy exercise habits with variation in body movement, a good diet, and good posture. 

We’ve previously covered the essentials of a good diet, and you can find our posts on “Minerals and Why They Matter” and “Vitamins and Why They Matter” below:

Upcoming posts will focus on ergonomics, the fundamentals of good posture, and how to achieve it. Cheers

REFERENCES:

https://www.cdc.gov/mmwr/volumes/67/wr/mm6736a2.htm

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2677657/

https://www.ncbi.nlm.nih.gov/books/NBK222423/

https://pubmed.ncbi.nlm.nih.gov/17602999/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3939594/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4619092/

https://www.sciencedirect.com/science/article/abs/pii/S0304395904005445

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5546756/

To initially learn about how muscles weaken when constrained to one position, it’s useful to develop a visual analogy. Muscles always cross some joint while connecting to a minimum of 2 bones. They can be lengthened or tightened through stretching and exercising, respectively. For example, by exercising the biceps, you will over time, shorten the muscle and increase the resting muscle tone. It may help to thing of the muscle like a piece of rope, with the end goal being to get the piece of rope to its ideal length, through lengthening and tightening (with the means being exercise and stretching). With neglect and sedentary lifestyle habits, these “ropes” lose their length and tightness, requiring effort (in the form of exercise and stretching) to bring them back to their ideal state.

The graphic above shows some common postures when sitting at a desk. As mentioned earlier, the muscles and tendons adapt to the conditions to which they are placed in – in the case of incorrect postures, the muscles and tendons begin to support the resulting musculoskeletal imbalances, leading to a variety of health problems down the line that could even comprise mental health and digestive issues. If we take the second incorrect posture, with the individual hunched over the desk, the thoracic (abdominal) region of the erector spinae muscles will hyperextend (over lengthen) and weaken. This is because A) The muscles are being stretched constantly, without any compression and B) They are not being exercised to shorten them to their ideal length. Remember that rope analogy from earlier? You can use it to visualize what’s happening here. Another issue is that the ligaments covering the spine will loosen on the posterior (back) side of the spine from being over-stretched. This could result in disc-related issues down the line, not a pretty sight to think about, let alone experience.

When you sit at a compute for prolonged periods of time, the following things are going on in your body:

1. There is extensive posterior pelvic tilt. This is seen in the image below, and can be described as the end range-of-motion if you performed a hip thrust, or tried to hump something while standing.
2. Your lower and upper back muscles are in flexion, where the spine is curved backwards at a great angle and looks like the left parenthesis -> (
3. Your shoulders are positioned vertically over your thighs, and not over the pelvis, where they should be
4. Your head is extended far over your thighs, instead of being in line with your shoulders, placing excessive stress on your neck
5. Your forearms are pronated (rotated internally) to an excessive degree, applying unnecessary stress to your joints and tendons
6. Your iliacus and psoas (muscles comprising the hip flexors) are in a hyperextended position

This means that your body will adapt to the posture and muscular positions noted above. Below, a picture presents the effects of posterior and anterior tilt on the pelvic complex:

What does all of this mean for you?

1. The posterior pelvic tilt has been shown to contribute to chronically tight hamstrings, due to the shortened position they are subjected to
2. The natural inward curvature of your spine is reduced, and results in a more “flat” lower back. This causes thoracic stiffness, and forces your pelvis into posterior tilt when standing
3. The flexion in the upper back muscles translates into excessive kyphosis while standing – have you seen Quasimodo? Yeah, that’s not a very attractive outcome. In addition to the slightly unattractive posture, excessive kyphosis has been known to cause shoulder impingement, chronic headaches, and additional issues that would seriously detract from the quality of your life.
4. The shoulders are positioned over the thighs, instead of over the pelvis, which contributes to a kyphotic posture in combination with the upper back flexion. This means A) your upper trapezius muscles are very shortened, and overactive to the point of being engaged with any arm movement and B) your levator scapulae is overstretched, which could result in migraines and neck pain down the line. The quick fix would be to massage these areas, but that’s not as sustainable as fixing the root cause altogether.
5. Your psoas and iliacus muscles, are going to become weak from constantly being in a relaxed position. This means that your your knees and pelvis are not positioned directly over your ankles, but rather in front of them. Your upper body compensates for this forward position by leaning backwards, putting your hip flexors into an elongated position, similar to what happens when sitting down.

Having read this, how do you fix all of this?

To be fair, this post makes strong generalizations about how the average human’s body responds to a sedentary lifestyle. You may not be the average human. You could play sports, be old, be fat, have joint disease…anything other than typical to be honest. It’s entirely possible that some individuals’ bodies will react in the exact opposite way to what is expected from doing corrective exercises. That situation is far from ideal. I don’t wan’t you to injure yourself when the purpose of this blog is to live a healthier, higher quality life.

For now, the best thing to possibly do is to massage your back, using a foam roller, the efforts of a close friend or family member, or by getting a deep tissue massage. Another test can be done by lying on your back, on a hardwood floor. Have a friend try to fit their fingers underneath your lower back, when you are relaxed. If the fingers don’t fit, you may have a slight degree of lordosis. If they are able to get a tennis ball under there, that’s a very big issue…That being said, this sitting issue applies to everybody, athlete or not. We all sit, meaning our body has gotten used to and good at sitting. You need to have this fact in mind before coming up with a corrective/rehab plan to get the best results.

Shown below is a picture of stretches that help you deal with lower back pain and tightness in the lower back muscles:

Sources:

1. https://exrx.net/Kinesiology/Posture
2. https://www.t-nation.com/training/neanderthal-no-more-1 (Parts 1-4)

I’ve been through a good amount of physical pain, back and hip injuries resulting from poor posture, and have had to scour the internet for knowledge from doctors, therapists, and academics to make my life a bit better. Fortunately, there is hope to increase the quality of life significantly and eliminate pain. Physical therapy and rehabilitation is not rocket science.

How do you know if you have pain in a certain area? You simply know the affected area hurts…it’s not that complicated and you don’t need a medical professional telling you that something is wrong with your lower back if it hurts all the time. Ibuprofen and acetaminophen are not the cure to your problem. Many people, including some of the HTW readers, have been suffering mild pain in, say, their knee, for a decade or two. The pain wasn’t “too bad” after their first medical visit, which could not find a remedy, they just put up with it and took painkillers/NSAIDs on a regular or occasional basis. Those people should be able to get the most out of a rehab program, and should read these relevant articles.

These posts are not targeted towards those affected by chronic joint diseases such as osteoporosis and arthritis- these diseases have more of a molecular component that may be slightly relieved through exercise, stretching, and massage, BUT requires more of a medical approach involving diet and therapeutic remedies. I don’t have any experience with these conditions and am not qualified to pontificate on the subject.

Take ownership of your problem, educate yourself, and increase the quality of your life. Just put in the work. The articles on HealthTrumpsWealth will point you to the right path.