How Mental Stress Can Affect the Musculoskeletal System
In our face-paced society, mental stress is inevitable at times. But did you know that when mental stress becomes chronic, it can show up in different ways in our physical bodies? For example, chronic stress can elevate our baseline heart and respiratory rate which will place more demand on the cardiovascular system, it can create gastrointestinal distress, it can lead to nervous system disorders, and it can cause issues with reproduction. As a physical therapist, I have seen many cases of chronic and unmanaged stress affecting the musculoskeletal system. In this blog, I will discuss the most common ways that stress affects the musculoskeletal system and what we can do to keep our physical bodies healthy in the face of stress.
Chronic stress leads to an increase in tension in our muscles and connective tissue. This can cause spasms in the muscles and physically constrict the connective tissue. Muscles attach to bones, so if the muscles are tense and spastic then they will pull on the joints causing an increase in joint stiffness. Over time this joint stiffness and muscle tightness will likely cause postural issues. When we have postural deficiencies we have a higher likelihood of developing continued muscle imbalances which can lead to injury.
Chronic stress also causes an increase in nervous system sensitivity. So movements that may not have bothered you in a stress-free environment, may become painful when under chronic stress. Stress also releases chemicals that cause inflammation and can lead to a systemic increase in low-level inflammation which can be toxic to our joints and muscles over time.
The two most common areas where we see chronic stress present in the musculoskeletal system is in the neck and low back. A common postural dysfunction results from weakness in the upper back, tightness in the pecs and upper traps, and a forward head and rounded shoulder position. This is a very common posture that people adopt when stressed and is made worse with the multiple hours of screen time that has found its way into our daily lives. This postural dysfunction can lead to issues such as tension-type headaches, chronic migraines, TMJ disorder, and shoulder impingement syndrome to name a few.
Lower back pain is another very common stress-related complaint. A common postural dysfunction that we often see in the low back related to stress and too much sitting is an anteriorly tilted pelvis. This is due to tight low back and hip flexor muscles, and weak core and gluteal muscles. A recent study showed that people under severe psychological stress are 3 times more likely to develop low back pain compared to the general population. Low back pain is also the leading cause of missed work world-wide and places a substantial burden on the health care system in the US with Americans spending over $100 billion annually in the management of low back pain.
I promise this is not a total doom and gloom blog. There is good news!
Since many orthopedic conditions involving the spine are stress-related or complicated by chronic stress, there is hope that these conditions will improve as we begin to lessen or eliminate stressors in our daily lives. It is unrealistic to believe that we will be able to eliminate all stress from our lives but it is important to first identify the things that are causing undo stress and then determine if there is a realistic path to lessen or avoid those things. For example, if you feel you are inundated with constant emails at work and never can get ahead of them, perhaps you stop all email notifications and block your schedule for an hour each day to just handle emails. In that hour, your sole focus is email management and once that hour is over, you do not check your emails again until the next day at the allotted time. That way you aren’t constantly getting pulled away to answer emails throughout the day. I understand that this does not apply to every situation, but this idea of blocking your day with clear tasks and designated time frames to complete those tasks can be very helpful in managing work-related stressors.
One other tip to help manage stressful situations is to monitor your breathing. So often when we are stressed we are in a very cerebral state and we aren’t really aware of what is happening in the rest of our body. This disassociation from the physical self is another thing we see often in physical therapy with people with chronic stress and pain. The practice of taking a moment to take stock of the physical self by slowing your breathing and clearing your mind is the basics of meditation and can really help to lessen stress levels. Even if this is just for a minute or two a few times a day, this practice can be life-saving.
Once you have identified your major and minor stressors and have a plan in place to lessen some of them, it is also important to engage in healthy regular habits. We can not underestimate the importance of “The Big 3” to healthy living. The “Big 3” are nutrition, sleep, and exercise. Usually in a state of stress, one if not two or three of these variables is not functioning at full capacity. It’s wild how many ailments can be solved just by listening to your body and not over-eating when you are already full, getting 7-8 hours of sleep a night, and exercising daily.
If you feel like you are crushing it with “The Big 3” to the best of your ability and you are still feeling overwhelmed and stressed you may need additional nutritional support or supplementation. This is where a functional medicine practitioner can be super helpful. From my own experience, I have noticed improvements in my energy level, mood, gut health, and skin just by taking the supplements that my functional medicine doc prescribed to me based on my blood work results. When our physical bodies are functioning well, we are better able to handle the psychological stressors the world throws our way and thus start to limit our physical pain.
I hope this blog was helpful and hopeful to those that may be dealing with chronic pain. We do not have to bear it alone. If you need any specific advice, please do not hesitate to reach out to us at info@outlasthealth.com.
Stay happy and healthy!
Shannon Hall, PT, DPT
