Do you remember the last time a tiny incident, say someone cutting you off in traffic during rush hour or the lift you are in stopping mid-flight, triggered an intense response of fear, anger and frustration—your heart beating fast and your palms sweating? That is an acute stress response in action, with your body going into fight-or-flight mode.
Your brain and body respond to negative stress, whether real or imagined, and chronic stress can have a profound impact on your health; for instance, it can cause nagging pains in various parts of the body where we "hold" stress, such as the back, shoulders, and neck. The symptoms of chronic pain and chronic stress overlap and often feed into each other.
Now, research has shown that along with several well-known ways to manage chronic stress, such as yoga, mindfulness and meditation, and even high intensity physical exercise, chiropractic therapy and spinal adjustments can decrease your cortisol levels, reducing the impact of chronic stress on your body. The connection between pain and stress has been studied closely in the last 20 years: in the 2014 study Chronic Stress, Cortisol Dysfunction, And Pain: A Psychoneuroendocrine Rationale for Stress Management in Pain Rehabilitation published in the Journal of the American Physical Therapy Association concludes that physical therapists should consider screening for non-pain-related stress to facilitate treatment, prevent chronic disability, and improve quality of life.
We speak to Dr. Prathap R Addageethala, Director and Head of Chiropractic, Atlas Chiropractic and Wellness, Bengaluru, to understand how physical therapy such as chiropractic management can help patients deal with the effects of chronic stress:
We usually hear of chiropractic therapy being used to relieve chronic pain like back pain. But does it also play a role in managing chronic stress?
Stress and pain are two branches of the same tree, where often one creates an increase in the other. For example, you might see a manager with chronic headaches, which worsens during the end of the month when work stresses are higher. In other cases, just the fact that there's an unrelenting pain can increase a person's stress. Because the body's response to stress is neurologically regulated by the brain (which feels the stress) and the nerves (which deliver the response to the stress), the spine is a very important structure in dealing with both of these issues. Correct movement of the spine cannot only help with chronic pain, but can help interrupt the vicious cycle of stress-induced pain, or pain induced stress. The correct function of the spine improves the communication between the brain and body, optimizing the pain and stress response.
What kind of physical effects does chronic and long-term stress have on the body, especially in terms of musculature, pain, posture etc.?
There are a number of physical effects that chronic stress causes, that are still somewhat mental in nature. Things like anxiety, depression, sleep disturbance, and headaches are very commonly documented with patients undergoing chronic stress. When we extend the nature of stress to a neurochemical standpoint, we often see elevations in the hormone cortisol, aptly named 'the stress hormone.' Cortisol is often the trigger for physical stress, pain, and uncontrolled inflammation. Inflammation creates havoc biomechanically, with respect to the muscles, joints, nerves, and the normal function of each. The interesting thing about stress is that a mental trigger can have physical effects, through this pathway involving cortisol.
When you talk of chronic stress, would this include people who have high-stress jobs where they are battling deadlines, targets etc? How can chiropractic therapy help them? When should they seek this intervention and how often do they need therapy?
The term 'chronic stress' actually implies the length of time someone is under stress. Anything over a prolonged period of time (about 6 months) would be considered chronic in nature. Realize that the term chronic does not connote any information about severity, just as a point of clarification. People who have jobs which require prolonged attention, difficult targets, or are responsible for something with high stakes, are all susceptible to stress. Chiropractic treatment can help these people alleviate the physical elements that stress creates, including pressure on the muscles and joints. Chiropractors are also excellent resources who offer ergonomic advice, stretching, and exercises, along with lifestyle modifications that can help reduce stress and improve the overall well-being of their patients long-term. Anyone who recognizes increased stress levels, postural issues, or pain of any kind are recommended to seek care immediately. Usually intervening early can reduce the severity of symptoms and keep the overall amount of input required low.
Regarding the frequency and duration of treatment, it always depends on the individual. We take care in assessing each person's condition, and all the parameters inducing their particular condition. It may look like a patient requires lots of care with frequent visits in certain situations, but if the care plan increases stress, that would be counterintuitive. We try to build something adaptable and flexible that everybody can commit to, and push for results in key areas with treatment.
How is chiropractic care different from, say, massage therapy?
Let's say you accidentally drive your car into a tree and it is immobilized. Would you proceed to give it a car wash? That's massage. If you chose to give it an oil change, that's medicine. Obviously, chemical or superficial treatment to your mechanical damage is not going to get that car moving. This is the analogy I often use when describing the ineffectiveness of the more commonly chosen healthcare methods. If you're stressed, and 90 minutes of soothing music and massage is what you need to get away from it all, that's excellent, and I definitely encourage it, where applicable. Chiropractic is a much more in-depth science and healthcare method by comparison. We look at the nerves, joints, and muscles whenever we apply treatment to a patient, as opposed to just the muscles as in massage. Chiropractors specialize in the Chiropractic Adjustment, a unique application of technique, where we mechanically manipulate the spine and other joints of the body. Manipulation of these areas can improve range of motion, reduce pain and stiffness, reduce restriction, and facilitate communication from brain to body. Since your nervous system controls literally everything in your body, it makes sense to keep it optimized. That is the central tenet of chiropractic treatment.