Stress and lower back pain in our every day life

Stress and lower back pain in our every day life Blog    Stress and lower back pain go hand in hand this day and age. It is a common and almost universal physiological problem that appears to be an epidemic in modern America. While stress itself is not the cause of lower back pain, it can exacerbate an existing injury. Once a person has injured their back from lifting or another physical activity, the back pain can end up recurring over time due to outside factors. Although it is a problem that affects the nervous system, prolonged events can eventually take their toll on the musculoskeletal system as well. During stressful moments, the area in the brain known as the hypothalamus is triggered and releases hormones into the bloodstream. These hormones activate the adrenal gland, which causes it to release a hormone known as cortisol. This hormone is one of the primary factors, as it causes our brain to kick up its responses to stressors and react accordingly. This process is not necessarily caused by prolonged stressors. As an example, if someone steps on the road and a car goes speeding past and startles the pedestrian, cortisol and adrenaline are released. Cortisol has a wide range of functions in the body, such as the brain’s glucose utilization, accelerating tissue repair, heightening immune response, and reducing inflammatory responses. Cortisol also reduces the activity of both human growth and reproductive cycles, in addition to the digestive system. Stress is usually regulated by the body and is self-controlling.

However, if stressors increase or are sustained for long periods of time, a physiological problem is created. The person will constantly feel on edge as the hormone levels stay in the tension stage. The body is unable to regulate itself at this point, which means the fight or flight reaction is kept on. When the person has no control over stressors in his or her life, the brain is unsure of when to turn off the hormones and the person is more likely to remain tense. A day in the life of an average American today can be very demanding.

Most people now work overtime and take less vacations as they take on more workloads and higher work responsibilities overall. When they do take vacations, Americans often find the preparation itself stressful. At this point, it is necessary to find solutions to reduce stress levels once more. This can be done through physical and massage therapy, visiting a chiropractor or acupuncturist, and a balanced diet. Most people who go in for physical therapy are dealing with many stressors that are applied to their lives through long commutes and the physical demands of their working life. It is at this time they need to find out how to control these factors and reduce effects on the body.

The tensions of daily life in particular relate to back problems through the aforementioned response of the adrenal glands. As the brain continues to release hormones, these glands become fatigued and the nerves related to the adrenal system can be affected. The third lumbar vertebra, or L3, is most affected by this fatigue due to the peripheral nerves around the spine. Any muscles surrounding the area are affected by the nerves, which causes them to contract and creates improper balance and pain points that can be triggered by other factors. The effects on these points eventually cause a limited range of motion and radiating pain from the affected area. Going to physical therapy will assist in reducing this pain through applied techniques that help increase joint mobility and reduce tension on the lumbar area, as well as strengthening the related muscle groups. Stability exercises and other preventative measures can be applied to help increase mobility of these joints, in particular the Sacroiliac joint. These exercises help strengthen weakened ligaments as well as loosen up tight muscles, both of which are the root cause of back pain. Physical therapy helps reduce low back pain through flexibility exercises, strength training, and manual techniques that help return joints, ligaments, and muscles to their normal range of motion. These techniques are used in conjunction with the patient’s own home exercise training which focus on stability and posture to help with proper movement during daily activities and reduce overall pain from stressing factors. Through all of the above methods, plus the patient’s own personal training, physical therapy helps in relieving tension and preventing the body from further injury.

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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

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Complete tear of rectus femoris
with large hematoma (blood)

image

Separation of muscle ends due to tear elicited
on dynamic sonography examination

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