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Is Your Job a Pain in the Back?

Your project is late, your phone won't stop ringing, and your back is acting up again. If that scenario sounds entirely too typical, your stressful work life may be a key cause of your aching back.
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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.

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Understanding Back Pain -- Diagnosis and Treatment

Before a doctor can begin treating back pain, he or she may do tests to diagnose what is causing your problem. Unless you are totally immobilized from a back injury, your doctor probably will test your range of motion and nerve function and touch your body to locate the area of discomfort. Blood and urine tests may be done to be sure the pain is not caused by an infection or other systemic problem. X-rays are useful in pinpointing broken bones or other skeletal defects. To analyze soft-tissue damage...

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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 back.

Stress Seeks the Weakest Link

"Back 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 subside."

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].

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