Health Blog

With various concerns affecting the nation at the moment it is hard to avoid elements of stress.

In my work as an Osteopath, I often use the word “load” when discussing with a patient what may be the cause of their musculoskeletal pain. This ‘load’ may be a repetitive action, a one-off incident, weight-related or a psychological aspect resulting in stress.  

I am focusing here on the psychological element:

Our bodies are clever and will adapt to situations when required.  I am sure that you all know about the fear: fight or flight response.  This is controlled by our subconscious to stimulate the body using hormonal release (Autonomic Nervous System). Obviously, running the body at this heightened state increases the ‘load’ on various systems and structures – like driving a car fast.   This is fine for short periods of time but if maintained over long periods will result in pain or ‘breakdown’.

The body will release more hormones such as Glucocorticoids, Catecholamines, Growth Hormone and Prolactin.    These increase energy and adapt the body to the situation by, effectively, speeding it up.    One of the key effects is to reduce the blood flow to non-essential systems and redirect it to skeletal muscles, such as increasing the heart rate, breathing faster, running faster, etc.    When the response is no longer required blood is then redirected to the digestive, immune and reproductive systems.

A situation where there is ongoing long-term stress – such as a marriage breakdown, living with a sick partner, financial worries, work issues – will result in the stress response remaining high.   This is when the “load” on various systems will start to cause symptoms.      If your blood pressure remains high for a long period that is when the danger of something leaking or bursting (stroke) may happen, but often prior to this there may be joint and soft tissue discomfort.     Similarly, collagen production is reduced when under stress, this will reduce the soft tissue recovery after activity or damage.   Muscle tension will remain high which will fatigue the muscle and potentially lead to strain.

As practitioners we sometimes get patients who question why we want to know so much about how or why their discomfort started and are familiar with being asked, “Can’t you just click it?!”   Sometimes an onset may seem to be obvious but may not match the period of recovery that we would expect, this is where looking into whether there is a background long term stress response can help to manage the progress.     Simply identifying a background cause may help the patient to make different decisions that avoid compounding the issue.

Hyperventilation

Hyperventilating (increased rate of shallow breathing) is a common response to stress (divorce, health issues, new baby, fatigue, financial worries etc).  The sensation of hyperventilating leads to feeling unwell, resulting in more anxiety then more hyperventilating and can become a cyclical problem.

Chemical changes occur as a result of hyperventilating with the main one being that the level of CO2 in the blood drops.  This changes the pH levels in the blood and will result in some symptoms associated with the nervous system and emotional symptoms, again compounding the issue.    Reduced calcium levels due to the increased pH levels can affect the function of most cells in the body, but particularly nerve and muscle cells, hence resulting aches and pains.

Panic hyperventilating is normally quite obvious, but more chronic hyperventilating may not be obvious and is often missed.

Mechanical changes are tension in the muscles around the neck that lift the chest.  These muscles are normally only really used when deeper breathing is required such as during exercise.   Excessive use results in fatigue, felt as aching and pain.    The diaphragm is the main muscle that controls the changes in pressure within the chest to allow air in and out.   During hyperventilation the diaphragm does not fully relax. 

Osteopaths will be able to help the soft tissue and joint function changes with hands on technique and advice on self-help exercises.   They will also help you to identify the causative issue.  We are fortunate that within the clinic we have a large number of practitioners offering a diverse range of modalities that we can refer to if required, such as Psychologists, Soft Tissue Massage Therapists and Acupuncturists.