Your health and Anxiety

Pain is extremely disruptive, with back pain easily one of the most common types of pains to experience. If you’re prone to anxiety, then it’s possible that you’ve been suffering with regular back pain for years as a result of it.

Back pain from anxiety is common, and while it is certainly not the main cause of back pain, it is a reason that some people end up getting help for their anxiety. So what causes back pain, and what can be done about it? We explore these thoughts in this article.

Causes of Anxiety Related Back Pain

There are many different issues that can lead to back pain, and it is helpful to speak with a doctor to determine what your cause may be. When anxiety contributes to back pain, it is believed that the cause of back pain from anxiety is mostly secondary – meaning that anxiety isn’t literally causing back pain, but anxiety is causing behaviors that lead to back pain. 

There are many theories that describe a situation where back pain may be directly caused by anxiety. The most common is theory is that anxiety, which causes muscle tension, may be tensing muscles in the upper or lower back, and that that muscle tension causes pain in anxiety sufferers. 

Massage therapists will tell you that their most stressed clients often have knots in their muscles, especially in their shoulder and upper back, so anxiety-related back pain really does exist.

But anxiety may also be causing separate issues that simply lead to back pain. These include:

• Changes in Posture Anxiety can cause people to change their behaviors and posture, including the way they sit, what they do when they sit, whether they slouch, and so on. Changes in posture – especially when combined with the muscle tension from anxiety – can cause the muscles to be in uncomfortable positions and ultimately lead to back pain.
• Inactivity Anxiety may also change people’s physical activity levels. Activity plays a direct role in back pain, and healthy physical activity tends to make the back more mobile and less receptive to general aches and pains. If someone reduces their activity levels because of anxiety, it is possible that will lead to back pain. Sometimes the two issues develop together, however – inactivity can lead to anxiety, which may indicate that they are separate conditions with similar contributing factors.
• Hypersensitivity Another issue related to anxiety is hypersensitivity. Those with anxiety tend to experience physical sensations more than those without anxiety. As such, mild back pain – the type of back pain that normally wouldn’t change your activity levels – could feel more severe and be harder to ignore, which in turn would lead to adjustments that may contribute to further back pain.

Anxiety isn’t believed to cause severe back pain. But it’s also important to remember that there is often a back pain cycle. Those with greater perceived back pain (either because the back pain is severe or because they are hypersensitive to the pain) are more likely to over-adjust in an attempt to avoid the pain.

Chiropractors see this often. A patient with mild back pain will make their back pain worse because they’re constantly walking, sitting, or twisting in ways that are unnatural in an attempt to reduce that back pain.

So while anxiety may not cause severe back pain on its own, a person’s reaction to their anxiety related back pain could potentially be contributing to more severe pain.

Similarly, some people experience further anxiety as a result of their back pain, regardless of whether the initial back pain was caused by anxiety. Since anxiety can cause back pain because of muscle tension, posture changes, etc., this may also make the back pain worse. While it may not have been initially caused by anxiety, anxiety contributed to the back pain cycle.

How to Stop Anxiety From Causing Further Back Pain

Under the assumption that your back pain is caused by anxiety, treating that back pain does require a focus on the pain itself. Unfortunately, while treating anxiety can reduce your back pain in the long term (more on this later), breaking the cycle of back pain depends in large part on your ability to also fight the back pain itself. Consider the following tips:

• Stretch Stretching is incredibly important. You need to keep the muscles stretched and nimble to prevent further pain. Make sure you’re stretching regularly in order to avoid any “freezing” of the muscle that may create pain. Examples of this type of stretching include lying knee twists and the cobra stretch.
• Watch Your Posture Overthinking your posture isn’t always helpful, but it is important to pay attention to any obviously bad posture that you may do as a result of your anxiety and stress. If you’re sitting in a clearly bad position, try fixing it with better posture and see if that offers support. 
• Painkillers Over the counter painkillers are still a useful way to combat back pain. Even though your back pain is anxiety related, drugs like Tylenol are specifically designed for pain, and this pain can still respond well to painkillers. You may benefit from these treatments.
• Exercise and Be Mobile Unless your back pain is so severe you cannot move, and if you’ve been advised to stay active by a doctor, try to be mobile. Walk around, exercise – do activities that keep your back strong. Don’t over-exert or risk injury, but make sure you’re not forgetting the value of physical fitness.
• Massage Massage is a very useful tool for both back pain and stress. It is a great way to work out the pains in muscles, and when you’re done you’ll often find your back is less painful than it was previously.

These are all traditional ways to deal with back pain unrelated to anxiety, but they’re still effective because once back pain starts, it needs to be stopped using traditional methods.

But of course, controlling your back pain is only step one. You will still need to learn ways to cope with anxiety so that you can stop your anxiety back pain from occurring again.

Types of Anxiety Bowel Problems

Your entire digestive tract is incredibly complex. There are plenty of medical issues – some common, some more serious – that can alter the health and behavior of the bowels, and lead to discomforts, wet stools, constipation, pain, and many other symptoms. From poor diet to illness, the bowels are often the place affected by a host of medical conditions. 

There are also many bowel issues that can relate back to stress and anxiety as well. But what is interesting about bowel issues from anxiety is that they are related in a number of ways, some of which may not even yet be clear. 

Below is a quick breakdown of some of the bowel problems that those with anxiety may struggle with. While it is not a comprehensive list, the bowel issues below are some of the most common reported issues and the ones that you or someone you care about may experience if they struggle from anxiety and stress related issues. 

Diarrhea and Constipation

Two of the most common bowel issues connected to stress and anxiety are diarrhea and constipation. Of course, these two bowel issues are linked to hundreds of different causes and conditions, which is why sometimes these issues go unnoticed or are attributed to a different cause. But anxiety is still a frequent cause and contributor. These basic digestive issues affect a large percentage of those that struggle with severe stress. 

Yet, interestingly, the cause of these issues is not always clear. Some possible causes are known, but it may be difficult to determine the exact mechanism that is affecting your particular diet. Some of the potential causes include:

• Changed Digestion – Anxiety releases adrenaline, and adrenaline may slow down the speed of your digestion. Any time your digestion speed changes, it may cause either diarrhea or constipation.
• Anxiety-Diet Changes – Sometimes, when people have stress, they change what they eat and drink. For example, if someone is suffering from anxiety related fatigue they may have more coffee to make up for it, which may cause diarrhea. Or they may eat ice-cream as a coping tool, leading to an upset stomach.
• Anxiety Related Sleep Deprivation – Anxiety can affect the quality of a person’s sleep, and sleep deprivation is also a trigger of diarrhea and constipation with a strong effect on digestion. 

These are only some of the links between anxiety and diarrhea/constipation, with its connection to other issues like the processing of nutrients, muscle tension, dehydration (from sweating), and countless other potential changes to hormones. 

The issue may also be related to neurotransmitters, the chemicals in the brain that affect emotions. The neurotransmitters that can lead to anxiety when out of balance, such as serotonin, are the same neurotransmitters telling your gut how to react. Thus, it is possible those with anxiety simply do not have enough of the specific neurotransmitters that are necessary for proper bowel functioning.

All of these can cause diarrhea and constipation. 

Gas

Another common bowel problem associated with anxiety is gas. During periods of anxiety when digestion is slowed and diet affected, the result may not just be diarrhea and constipation. It may also be gas, which the body creates any time digestion isn’t working properly. Gas can be both smelly and painful, and in some cases can lead to increased stress in social situations. 

There are other issues that may lead to gas and flatulence as well. Those with anxiety are prone to air swallowing and hyperventilation, and these can lead to excess air in the body. Usually, this air is released through the mouth, but in some cases, it can be released through the bowel instead. 

Discolored Stool

Another bowel issue connected to stress and anxiety, and one that often goes hand in hand with diarrhea, is stool discoloration. The effect anxiety can have on one’s digestive tract can result in food moving through the digestive tract too quickly. Because food generally gets its color as it moves down the intestines, moving too quickly can result in discoloration. These include:

• Yellow stool.
• Black stool.
• Grayish brown stool.

While this is a fairly common bowel symptom of stress and anxiety, if at any time you are concerned about your stool color, seek advice from a medical professional. 

Irritable Bowel Syndrome

There is an entire disorder that, in some cases, may be directly related to anxiety and stress. It is called irritable bowel syndrome. It is unclear whether stress and anxiety lead to IBS or simply exacerbate symptoms. Nonetheless, they often occur together.

Although symptoms of IBS vary depending on the individual, the associated bowel problems can take a significant toll on one’s life. Common IBS symptoms include cramping, diarrhea, constipation, gas, and bloating. 

The “Need to Go”

Finally, anxiety can also cause an ongoing feeling of urgency, or needing to go to the bathroom.

This is due to the fight or flight system being activated as a result of stress. Pressure builds up inside of the body, causing stool to feel like it needs to come out. Also, during times of intense stress, the body uses increased amounts of energy, leaving less energy to hold the anal sphincter in place.

How to Overcome Bowel Issues

Dealing with the bowel issues connected to stress and anxiety can be very difficult, as bowels function automatically. Seeking medical attention, exploring how different foods affect you and identifying ways to manage stress and anxiety are all helpful ways to begin to manage bowel issues.

Everyone – even those without any mental or physical health problems – occasionally experiences a feeling of malaise, where it is as though they have an illness or something wrong with them, but it’s almost impossible to identify what that issue is.

Those with anxiety seem to experience this feeling more than others. That brings up an interesting question: what is causing this feeling of malaise, and what can be done to prevent it?

How Anxiety Causes Malaise

Anxiety is a total body experience. It leads to significant changes all throughout the body on a chemical level, leading to issues that affect everything from stomach imbalances, blood flow changes, digestion issues, and more.

Malaise itself is often unidentifiable, and although you may be able to pick out some symptoms (like a bit of nausea, etc.), it’s often hard to exactly pinpoint what’s “wrong.” You may feel ill, or “off,” while not necessarily feeling truly sick.

Its causes are not well understood. Most agree there are combinations of triggers that cause malaise. Just a small selection of the issues that cause a malaise feeling include:

• Digestion Problems When you have anxiety, many things go wrong in your body. Your intestinal flora can increase. Your stomach starts to move food down your intestines at a slower pace. Certain nutrients go in and out of your body at rates not ideal for your overall health. Digestion and nutrition issues affect every area of your body and can lead to feelings of illness.
• Stomach Acids When you have anxiety, your stomach acids also change, often increasing. An increase in stomach acids may cause your stomach to feel ill.
• Nausea (General) Other issues may cause feelings of nausea as well. For example, there is some evidence that certain hormones and neurotransmitters released during anxiety tell your body to make you nauseated. This is why the gut is known as the “Second Brain” and supposedly extremely sensitive to even minor emotions.
• Adrenaline When you have anxiety, adrenaline is pumping through your body. That causes your body to experience stress. It changes your blood flow, and it puts your muscles on edge. It leads to fatigue. All of these issues can resemble what you would feel if your body knew something was wrong and may create this uneasiness that you can’t seem to shake.
• Immune System Changes Anxiety also alters the immune system, and the immune system is responsible for your entire body feeling as though something is wrong. That’s why malaise is common before an illness. It’s possible that when anxiety alters the immune system, the change in stasis leads to various physical ailments.
• Fatigue Anxiety is also incredibly draining, and fatigue can lead to a feeling of discomfort as well. When you’re fatigued, you often feel as though parts of your body are ill or sick, or your brain isn’t thinking/working clearly.

It should also be noted that anxiety changes brain chemistry, hormone function, organ function, blood function and air intake, glucose, and nutrient availability, and more. There are so many different changes caused by anxiety that any number of them can cause this type of malaise feeling.

Intensified Normal Feelings

Perhaps even more relevant is that not all malaise is actually malaise. Another symptom of anxiety is an oversensitivity to physical sensations, where the way that you feel is amplified because your mind focuses on it too much. For example, being full after a meal is not that great a feeling, but most people ignore it. Those with anxiety simply can’t ignore it no matter how hard they try. They focus on it, and it feels worse to them than it feels to others, making you feel sick or ill.

Every time you eat something that doesn’t make you feel great, or you are sitting in a position that pushes on your stomach, or anything that can cause any change in the way your body feels, you may find yourself noticing it more than someone without anxiety would and feeling ill as a result.

Are There Ways to Overcome Malaise?

Malaise is a subjective feeling that is hard to describe, and that makes it hard for you to necessarily overcome it since there may not be anything to overcome.

The best thing to do is take care of your overall health first – not just for your anxiety, but also so that you can ensure that your body has everything in needs to prevent anything that can trigger malaise unrelated to your anxiety. Make sure you’re properly hydrated, that you’re eating foods that you digest well, that you’re sleeping, and more.

You should also make sure that you start exercising. Exercise is a crucial component in hormone production and use and has a calming effect on your mind and stomach. Exercise is something you absolutely must do in order to effectively reduce your anxiety.

But almost all of the issues that lead to malaise are related to processes inside of your body that you can’t control without stopping your anxiety. You can’t turn off adrenaline or improve the health of your intestinal flora unless your anxiety is kept under control.

Steve Ramsey, PhD- Public Health.