Low Back Pain and Chronic Headache

If you find yourself suffering from chronic tension or migraine headaches at work, you might suspect eye strain from too much screen time. While this is often the case, if you also suffer from chronic low back pain, the two might be related according to a systematic review of existing research (Vivekanantham, Edwin et al., 2019). Typically, headaches and back pain are treated by different types of specialists, which might not be the best approach. Researchers in the U.K.  wonder if outcomes might be better if the two interrelated conditions could be treated together.

Headache and low back pain are among the most frequent causes of chronic pain. Migraine and tension-type headache affect more than ten percent of the world’s population (Vivekanantham, Edwin et al., 2019), while non-specific low back pain is a leading cause of primary care physician visits both in the US and abroad. Although the relationship between upper spine, upper back muscle dysfunction and cervicogenic headache is well-established (Park, Yang et al., 2017), the impact of low back pain on chronic headache has only recently attracted attention.

A third contributor is so-called mood disorders such as stress, anxiety, and depression. An individual’s experience of chronic pain is highly subjective and emotionally charged. In addition, there is evidence of genetic overlap between migraine and depression (Vivekanantham, Edwin et al., 2019). Chronic migraine frequently increases levels of stress and anxiety (Kim, Bae et al., 2021). Those affected tend to have low self-efficacy, feeling ill-equipped to manage their pain. The relationship between mood disorders, chronic low back pain and chronic headache tends to be synergistic, creating a downward cycle for the patient.

While patients must rely on medical providers to treat the physical symptoms of low back pain and headaches, it is possible to address the stress and anxiety through some simple lifestyle strategies. A symptom diary is a good place to start, and a good tool for working with your provider on a treatment strategy. Record when and where you experience symptoms, whether you are alone or with family, friends and colleagues, as well as your physical and emotional symptoms. Keeping such a diary for a week when you are symptomatic should yield valuable information.

Chapter 2 of Chronic Back Pain: A Self-Management Framework, available on this website, talks about maladaptive thought patterns. Are you bringing some of the tension at work upon yourself by attributing more significance to small incidents than they deserve? Do you tend to predict negative outcomes for future events? Perhaps you are mind reading about colleagues’ negative evaluation of your projects without any real evidence. Most of us fall into one of these traps at various points in our lives. In addition to increasing stress levels, such thought patterns can lead to sleepless nights, which in turn can exacerbate back pain and headache severity.

Consider some simple lifestyle modifications. The book suggests deep breathing for relaxation. Take stock of your nutrition: are you getting enough of key nutrients by eating enough fresh fruits, whole grains, and lean protein? Are you staying adequately hydrated? Are you staying active? Short walk breaks out of doors in the good weather are a great way to reduce tension levels, and gradually increase your fitness level.



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