Back pain and COVID

Has the prevalence of back pain increased during covid?

Over the past 18 months during the coronavirus pandemic there has been a marked increase in the prevalence of back pain and other chronic disorders. Why has this been the case and what has been the overriding reason for it? It this article we’ll look at the possible explanations for the rise in back pain complaints and whether it is a temporary blip or if this increased prevalence is here to stay.

Is Working from home bad for you?

During the course of the pandemic many of us have been working from home. Whilst at the beginning this may have seemed like a bonus, some people are keener than ever to get back to the office. Many of us went from a desk with a supportive chair and a computer screen at an optimal level to working at the kitchen table or slouched on the sofa or bed. Whilst the former is more conducive to supporting your posture the latter is certainly not and can have a dramatic effect on increasing postural related pain. Check out our article on sitting to find out just how bad sitting in an incorrect position can be for you.

Of course, the sitting element of working from home isn’t the only thing that has a negative effect on your posture. Perhaps the biggest change between working from home and the office is the lack of a commute. A commute will generally require a level of mobility, whether that be walking to the office or train station or even from the carpark to the office, generally speaking most of us will be more mobile if we don’t work from home, even if its slightly. This means that most of us who work from home will live a more sedentary lifestyle and living a more sedentary lifestyle comes hand in hand with chronic pain. This was compounded by the fact that for large portions of the pandemic gyms and leisure centres were closed meaning we couldn’t even offset our reduction in mobility in our normal fashion. 

Despite the ergonomics and restrictions imposed on our lives from working from home, you can see that they could be quite easily offset if desired. Setting up a home office with a suitable desk and supportive chair would help support your posture, whilst introducing set times in the day to exercise would help offset the reduction in mobility due to the change in routine. 

We can see how the ergonomics of working from home and the reduction in exercise could have a detrimental effect on our mobility and therefore postural related pain. But working from home, reducing our physical activity and having less human interaction are all things which affect another factor very closely related to pain….. mental health. 

Is my Mental Health the reason?

The past 18 months have taken there toll on our mental health. All of us have had to deal with stresses and worries about the coronavirus to some extent. Worrying about our health or the health of our loved ones, about our job security or if our career will be sustainable, about our mortgage payments or if our wedding plans will take place. The pandemic has impacted our mental health on so many levels. Human interaction has changed drastically…who could have imagined a world where we couldn’t see our loved ones.. or give them a hug. A world where the closest interaction our children could have with their grandparents at Christmas was over skype. These things have been devastating for our mental health …..and mental health and chronic pain are closely intertwined. 

A study involving almost 200,000 participants found that individuals who have back pain are also more likely to experience a range of mental health issues including but not limited to mood disorders, depression, alcohol abuse and anxiety disorders. Despite its high prevalence little work has been done to investigate back pain and its correlation to mental health. Not only does back pain affect your mental health, but metal health can also affect your back pain….. this if you think about it makes sense. Our brains, spinal columns, nerves and muscles are all connected. Pain is a direct response to a stimulus of a nerve receptor which is sent to your brain…. is it so hard to believe that process isn’t reversible?

Research has shown that chronic pain, anxiety and depression trigger similar parts of your brain, they have also shown that when left untreated, depression can worsen physical symptoms, lower your pain threshold and even escalate the intensity of your pain! 

Its all in your head?

Many who suffer from chronic pain have at times wondered if it’s all in our heads….or worse we’ve been told it. This can be compounded when after numerous GP visits and scans reveal no physical reason for the pain we are feeling… perhaps it is all in our heads? Well perhaps it is…but not in the way you’re thinking. 

We all have different psychological attitudes and outlooks about pain and the way we think about pain can greatly affect how we feel pain. Mental health as we know can be worsened by limited physical activity which in turn can lead to psychological distress….which then worsens pain! This causes the cycle of pain!

As mentioned previously being anxiety-prone, pessimistic and having catastrophic thinking will make any pain you feel worse than it may actually be. This is likely to be due to the fact that if you have these beliefs and attitudes your brain is likely to have irregularities in its chemistry, such as the production of dopamine as well as disruptions in emotional control. Have you ever thought about feeling pain….then as if by magic you suddenly do? Well emotional control, anxiety and attention can cause the feeling of pain to be intensified because you may not be able to control your distress, anxiety or focus on anything other than your pain.

The pain you feel can even re-wire your brain….changing how it functions. You see when your back pain begins the circuits of your brain relating to pain-sensitivity are impacted. But if your pain is long lasting, such as chronic back pain, your brain may switch activity relating to pain away from pain-sensitivity circuits to emotion processing circuits. This is why chronic pain and mental health are so closely intertwined and how pain can make being in control of your emotions difficult and vice versa.

Unfortunately, pain leads to greater mental health issues and mental health issues lead to worsened pain, turning into a cycle that can seem inescapable. Now that we’ve seen that our mental health can worsen our pain or even create it….how can we break the cycle?

Breaking the Cycle.

So we think we might be in the cycle of pain. How do we get out of it? Well, this requires a simultaneous attack on two fronts. We need to address our pain through increased mobility in the first instance whilst also attacking our mental health issues to reinforce the changes we are making. This won’t be a quick fix, but the good news is that it can be done. For ideas on how you can increase your mobility take a look at our free ebook, dynamically defeating back pain. 

Therapy can help manage any vulnerabilities you may have to back pain due to your beliefs or attitudes, changing how you perceive pain and helping you manage issues such as stress, anxiety or depression. Of course, therapy isn’t for everyone, and the costs can make this solution unattainable for many. It’s always worth to have a chat with your GP to discuss your mental health as they may be able to provide you with solutions that won’t break the bank.

Mindfulness has been proven to be very effective in managing pain and at re-wiring the mind-body disconnect. Mindfulness is essentially the ability to free your mind and to focus on the present… which is actually harder than you think, especially if your mind is pre-occupied by stresses and worries. There are numerous aps out there which can help assist you on your journey towards mindfulness through guided meditation, the benefits are wide and varied if mastered. Putting aside 10-20 minutes a day to practice mindfulness will really help you and your pain management and is well worth trying. 

Is it here to stay?

So there we have it, it really is no surprise that this pandemic has increased the incidence of back pain…its been a double whammy really, reduced levels of mobility due the restrictions imposed on us by the virus, whilst the levels of stress and anxiety have increased directly affecting our mental health.

Is this likely to be the new norm? Well, a lot of that will depend on the direction the pandemic takes and the financial impact it has had on us when it’s all over, but more than anything it will depend on how we deal with it both mentally and physically!