Susan, 38, has a high-stress job as a publicist in New York
City. She's also predisposed to back problems because she was born with a
misalignment in her hips. "I have to sit for long periods of time [at
work], so I get really, really stiff," she tells WebMD.
Stephen, 43, of Montreal, is under the gun at work and
at home. Seven months ago, he started a new company and got married in the same
week. He suffers from many of the ills that afflict people who work at a
computer all day, including back, wrist, and arm pain.
Low back pain is very common. It affects millions of people. In most cases, you don't need surgery for low back pain. But in rare cases, severe back pain can be a sign of cauda equina syndrome (CES), a condition that usually requires urgent surgical treatment. People with cauda equina syndrome often are admitted to a hospital as a medical emergency. Here's what you need to know about cauda equina syndrome.
Susan and Stephen are members in good standing of an
ever-growing club, one you don't want to join -- stressed-out white-collar
workers who find that their demanding jobs can become a real pain in the
Stress Seeks the Weakest Link
pain is probably the No. 1 reason for visits to doctor's offices, days off
work, disability, and litigations," says Gary Starkman, MD, a neurologist
in New York City who specializes in pain management.
The pain is usually caused by many different factors working
together at once, experts agree. Often, a physical factor, such as lifting or
sitting for too long, combines with stress, and the result is a painful back.
Where they don't agree, however, is about the degree to which psychological
stress on its own can cause back pain.
"Stress can surface anywhere a person has a weak link,
whether it be back pain, neck pain, headaches, or whatever," says
Rick Delamarter, MD, medical director of the Spine Institute at St. John's
Hospital in Santa Monica and associate clinical professor of orthopaedic
surgery at the University of California at Los Angeles. "If a person has a
propensity for back or neck problems, stress can easily bring them to the
surface or exacerbate them."
But according to physical rehabilitation specialist Michael
Saffir, MD, chairman of the Connecticut State Medical Society Worker's
Compensation Committee, "People can have muscle strain and spasm because of
psychological stress alone, but typically that's self-limiting. Take an Advil
and do some stretching and it will
John E. Sarno, MD, has a very different opinion.
"Psychological factors, as far as I'm concerned, are far
and away the predominant cause of physical symptoms of physical pain in the
workplace," says Sarno, professor of clinical rehabilitation medicine and
attending physician at the Rusk Institute of Rehabilitation Medicine at New
York University School of Medicine and author of the books Healing Back
Pain and The Mindbody Prescription.
"All the pressures of life can be considered
stressful," he says. "The human psyche is so arranged that in our
unconscious minds we do not like stress. As a consequence, we tend to develop a
great deal of internal anger to the point of rage. The reason people get
physical symptoms [is to be a distraction from this rage]. The physical things
the people are doing [like sitting or standing for long periods of time] are
not really the cause of the pain. The brain is simply taking advantage of those
physical phenomena in order to start the painful process going. The brain
produces this pain by slightly reducing the blood flow [to a muscle,
nerve, or tendon].