Stress Related Back Pain: Why It Happens and How Physio Can Help

Work’s hectic, the kids are sick, the in laws are in town… and now your back pain has flared up too? What are the chances!?!?

Surprisingly… quite high.

When life is running at your normal pace, a bit of stress can actually be a good thing. Imagine you are just about to walk into a big job interview, deliver a presentation to a crowded room, or sprint to catch a bus. In those moments, your body cleverly shifts resources to help you perform. Your heart rate increases, your brain sharpens and your muscles prime for action. Systems that are not needed for survival, such as digestion and reproduction, temporarily slow down.

This response is driven by hormones such as adrenaline and cortisol, often called the body’s stress chemicals. They keep you alert, strong and fast. Once the stressful event passes, your hormone levels should settle back to normal. Your body can then return to digesting breakfast, restoring energy to muscles and repairing any tightness or micro tears from that quick burst of activity.

When stress does not switch off

Problems arise when stress becomes constant. Deadlines stack up, family commitments increase, the sleep debt grows and sometimes a single major event can throw everything out of balance.

In these situations, cortisol levels can stay elevated for days, weeks or even longer. When that happens, your body struggles to heal effectively. Pain hangs around longer. Muscles stiffen. Sleep is disrupted. Digestion slows. Even your immune system can take a hit.

This is why people often get sick the moment they finally go on holiday after a big push at work. As the stress eases and cortisol drops, the body switches into recovery mode. The immune system suddenly gets the chance to do what it has been wanting to do for weeks, and the result can look like fatigue, muscle soreness or even catching a virus you were holding off.

Long term elevated cortisol has also been linked to:

• Increased pain sensitivity

• Reduced physical performance

• Difficulty concentrating and memory issues

• Heightened anxiety or low mood

And yes, flare ups of back and neck pain are incredibly common during high stress times.

So… What can you do about it?

The goal is not to eliminate stress completely. That is unrealistic. Instead, it is about giving your body the support it needs so stress does not take the driver’s seat, especially when pain is involved. Here is what can make a meaningful difference:

1. Reconnect with what brings joy

Laughter, social connection and positive interactions can help turn down the brain’s pain alarm. When you laugh, your body releases endorphins which are natural pain relievers and mood boosters.

• Meet a friend for a chat

• Watch something that makes you giggle

• Do something simply because it feels good

It is simple but scientifically powerful.

 2. Understand your pain, knowledge is calming

When pain strikes during stress, it is very common to expect the worst.
That worry itself increases tension and amplifies pain signals.

A Physiotherapist can help you:

• Understand which tissues are irritated

• Learn why stress makes pain feel stronger

• Identify movements that help recovery

• Build a plan that restores confidence

Pain often eases when the brain feels safe. Education is one of the best ways we achieve that.

3. Move your body, even a little counts

Movement nourishes your joints, reduces protective muscle guarding and boosts circulation which helps healing. The trick is appropriate and gradual exercise.

Try:

• Gentle stretching or mobility work

• A short walk to reset your system

• Breathing focused Pilates or core strengthening

We tailor exercise specifically to what your body needs during a flare up.

4. Prioritise sleep and recovery

High cortisol loves poor sleep and poor sleep makes pain worse.
Small, consistent habits help break that cycle:

• Create a wind down routine

• Reduce screen use before bed

• Maintain a regular sleep and wake schedule

Better sleep means a calmer nervous system and reduced pain.

5. Calm the nervous system

Stress keeps your body stuck in fight or flight. We want to guide it gently back into rest and repair.

Helpful strategies include:

• Deep breathing techniques

• Mindfulness or meditation apps

• Regular stretch breaks throughout the day

These reduce tension and help your body feel safe again.