Back Pain Myth Busting 3 – Stress doesn’t impact your recovery

You’re damn right it can, in a big way. And not in a hippy woo woo sort of way. I'm talking a scientific and biologically measurable kinda way. Now it’s going to get a little technical/nerdy, but hang in there. A book by Joyce and Lewindon (1) gives an excellent summary, ‘In the 1970s, Robert Ader, a psychologist and immunologist, showed that the mind and body communicate with each other in a bidirectional flow of hormones, neurotransmitters and cytokines. The brain and immune system represent a single, interactive system of defence. Thoughts, beliefs and emotions have neurochemical consequences on both the immune system and individual cells. Emotions and health interact. The immune system does not only fight sickness, it has a major role in tissue regeneration and injury recovery. Marucha et al. showed healing of mouth ulcers in dental students took 40% longer during exams than holidays.’

The interaction between all of these is governed by a little part of the brain, the hypothalamus. This little guy is super important as it organises everyday functions that we don’t even think about; body temperature, hunger, thirst, sleep, libido (wink wink). It also governs the body’s response to stress, acute and chronic. Acute stress response is very important. We’ve all heard of the flight/fight response, which is generally a good thing. Step onto road, oncoming car, jump back to avoid tackling a Ford Focus travelling 30km/h above the speed limit, give driver the finger, proceed to sweat profusely, feel heart palpitations, ponder the meaning of life, quit job and start painting like you always wanted to.

But chronic stress can be a bastard. It’s associated with overproduction of cortisol, and regarding injury recovery and rehabilitation, there is an increase in pro-inflammatory cytokines and decrease in anti-inflammatory counterparts. To sum up in one sentence, stress delays injury recovery significantly.

Lots of things and the rate at which it will slow recovery cannot be measured, but these factors can be mitigated. Sleep deprivation is big. You need at least the magic 7-8hrs/night. A study by Milewski et al. showed adolescents that go less than 8hrs sleep/night were 1.7x more likely to develop an injury. Same thing rings true with injury recovery. Sleep is the body’s time to recover and repair. Make sure you get enough.

Mood, emotions, anxiety and depression levels are all massive factors for injury recovery let alone holistic health, refer back to question 1 for the detailed answer as to how and why.

1. Mindfulness. Now this might be leaning a little toward the hippy side for some, but don’t worry you won’t have to identify your spirit animal just yet (cough...grizzly bear). Numerous studies have shown how a regular practice of mindfulness, in whatever form that may take for you, has a huge impact on your mental health. I’m a big fan of people like Tony Robbins, Tim Ferris, Gary Vaynerchuk etc. These guys have interviewed the top 1% of pretty much every industry out there, and about 80% of these high achieving individuals do some sort of mindfulness. A lot meditate, others do activities where time becomes irrelevant and they get lost in something they enjoy, and others have gratitude journals. The key is the disconnection from the stressful stimuli we are bombarded with and to give the mind a break. Good things happen here.

2. Set boundaries. Learn when to say no. Setting healthy boundaries allows you to do your job properly without getting too stressed out. There are a ton of analogies that work here. You can’t pour from an empty cup, you need to put your own oxygen mask on before attending to children etc. But seriously it’s true. Yeah, we know sometimes it’s difficult/impossible to say no to certain things at work and life. Learn how to set those healthy boundaries. You’ll thank yourself.

3. Exercise. It’s easily the best thing you can do for your body; physically, mentally and emotionally. A cascade of endorphins, dopamine etc. is released from the brain as a result of exercise and you feel pretty awesome. Have you ever noticed how good you feel during the day and how much you can accomplish when you set the alarm, get out of bed early and do some exercise before you get to work? It’s outrageous! Not to mention all the metabolic diseases you are fighting off one burpee at a time. 10/10 highly recommend.

If you missed last month's article from Queen Street Physiotherapy on whether exercise and movement is bad for back pain, check it out below.