I’m sure you are all tired of me harping on about stress. Especially when you come in with acute lower back pain and one of the first things out of my mouth is, ‘Are you under more stress than usual?’ I am going to try to explain to you here, why my question is relevant.

I should explain firstly what I mean by stress. Stress is any stimulus that is more than we can cope with and any stress causes muscle tension which can lead to pain.

Sources of stress-

  1. Physical – such as poor posture; a work position or a repetitive position; a trauma, old or new.
  2. Emotional – usually relating to either love money or job satisfaction.
  3. Chemical – such as pollutants, recreational drugs, medication, artificial hormones e.g. oral contraceptive pill, HRT, there are also artificial hormones in our foods along with herbicides and pesticides, processed foods, alcohol, nicotine, fire retardants in our pillows, mattresses and carpets; cleaning products, detergents, shower gels, deodorants; the list goes on and on…
  4. Temperature – this can be extremes in temperature but also can be caused by seasonal changes.

It’s a juggling act for your body. For example, let’s take a typical morning for many people. Stay in bed too long and therefore have to miss breakfast, it’s a really cold morning; run to get the train to find that it is standing room

Train travel during London to Brighton rush hour (ok- it's not but it sure feels like it sometimes).

Train travel during London to Brighton rush hour (ok- it’s not but it sure feels like it sometimes).

only; then the train is held up (due to leaves on the tracks!); you are going to be late for work and there is no air-conditioning in the carriage; you can read a newspaper over someone’s shoulder to discover train fares are going up again. So many stresses and you haven’t even got to work yet!

Now the interesting thing is the body doesn’t differentiate between these sources of stress. It’s just ‘stress’ and the body has the same physiological response – which causes muscle tension – which leads to restricted movement, inflammation and pain – getting how the stress maybe relevant?

Now in the old days, we’re talking stone-age here. We would react to the stress by either running away, over powering it or killing it. The body has a reaction to deal with any of these needs; it is called the Alarm Reaction or ‘fight or flight’ reaction. The body then needs to recover from the stress, or not. The human body today is virtually the same as it was 100,000 years ago, according to anthropologists. However, our stresses these days are very different, they are less extreme (a mammoth is not attacking us) but much more frequent and ongoing. We even experience stress while we think we are relaxing, e.g. watching a thriller on TV.

Nowadays, we are continually under stress but the situations cannot be dealt with by running away or punching someone (I wish) we just swallow, continue and then something else stresses us again in ten minutes. We appear to be continually under a myriad of physical, emotional or environmental stresses daily and we expect our adrenal glands to keep up with our demands. Our adrenal glands need time to recoup or they will become exhausted.

Let’s look at the Alarm Reaction in a little more depth and what it does to the body. So we are going to break this down into three stages: 1.Alarm, 2.Resistance and 3.Exhaustion.

1. Alarm

  • Stress stimulus initiates an emergency signal to a region of the brain called the hypothalamus, to command the anterior lobe of the pituitary gland to release a hormone called ACTH into the bloodstream. This will command the adrenal glands(stress glands that sit on top of the kidneys) to release cortisol which has the following effects:
  1. Causes sodium and water retention in the kidneys (prolonged stress can result in craving salty foods, e.g. crisps)
  2. Causes protein breakdown to sugar for instant energy so that you can either run away or fight. This can affect the immune system as initially the protein is taken from the thymus gland and the lymphatic system.
  3. Sugar is also released from the liver (stressed people crave stimulants, sugar is a stimulant)
  • Simultaneously the brain also commands that the adrenals produce adrenaline and nor-adrenaline. These three major hormones instantly mobilize the body for ‘fight’ or ‘flight’ by initiating the following:

a)     Shuts down digestion as it’s not necessary and shunts blood away from digestive organs to skeletal muscles.

b)    Bladder and rectal muscles relax.

c)     Heart rate increases, blood vessels dilate and blood pressure rises.

d)    Breathing becomes fast and shallow to supply oxygen to heart, lungs and muscles.

e)     Muscles tension increases.

f)      Sweat increases.

g)      Pupils dilate.

h)    Increases blood clotting.

For a few brief moments, these functional changes could give you super human strength enabling you save someone from a burning car etc. This strength is usually followed by a drop in hormone production, therefore, a drop in energy that could last for hours or days depending on the magnitude of stress and the condition of the adrenal glands. This is the recovery phase.

2. Resistance

If a body is repeatedly stressed, the adrenal glands enlarge. They do this to try to accommodate with the demand. The amount of time that a body can continue in the resistance stage is unpredictable; anything from a few months to 20 years but if new stresses suddenly arise, the body will eventually go into the stage of exhaustion.

3. Exhaustion

Excessive stress results in adrenal exhaustion which means the adrenal glands are unable to produce adequate hormones and our ability to adapt to stressful situations is decreased. I know this doesn’t sound like much but it’s a big deal if you’ve ever experienced it. This is burn out! Classic symptoms include lack of drive, fatigue, impaired memory, anxiety, and depression.

The guy who first described these three stages, known as the general adaption syndrome, was Hans Selye in 1925. He noted the symptoms accompanying stress which included rashes, fever, and inflamed tonsils. On the dissection of stressed rats he found enlarged adrenal glands, atrophied thymus, lymph nodes and all lymphatic structures (resulting in decreased immunity); stomach and duodenal ulcers, enlarged spleen or liver.

Graph showing alarm, resistance and exhaustion phases

Based on the preceding information a variety of health problems can be predicted with prolonged stress:

  • Stress headaches, neck/shoulder pain, back pain, jaw clenching/grinding
  • Skin conditions
  • Heartburn, nausea, constipation, diarrhoea, ulcers, IBS
  • Weight loss/gain
  • Colds, coughs and recurrent infections
  • Depression, anxiety, OCD
  • Insomnia
  • Fatigue or no energy
  • Allergies, autoimmune conditions
  • Fainting on rising
  • Decreased memory, concentration and learning
  • Swollen extremities
  • Heart palpitations, high blood pressure
  • PMS, infertility, sexual dysfunction
  • Increased susceptibility to addictions

There is no standard medical test for slight or moderate adrenal exhaustion so it is regularly missed. The symptoms, however, are usually treated, as opposed to the cause (medication in itself can be a form of chemical stress), which commonly results in more stress on the body.

Okay – so now you get the idea that the question of ‘have you been under more stress recently’ might be relevant. But what can we do to help our adrenal glands?

Well, the answer to that question will be in next month’s blog.  Bet you can’t wait!

Written by Anne French, Chiropractor.