back_painRecently while browsing the Pub Med research site and looking through articles on heart disease, I came across an interesting correlation.  One article cited a major cause of coronary artery disease to be “job stress”, no surprise; but in this case it looked at a specific employment situation. The Whitehall II study (24) found a 2.15-fold increased risk for new coronary heart disease in men who experienced a mismatch between effort and reward at work. The high-risk subjects were those who were competitive, hostile, and overcommitted at work, in the face of poor promotion prospects and blocked careers.” Essentially these individuals held moderate to high responsibility with very little control over their work environment.

Interestingly, about six months ago while I was preparing a report on the etiology of low back pain in occupational settings, I came across a few studies that found predictive factors for workers who are at risk for developing spine pain.  Low and behold, one of the top predictive factors is workers who have moderate to high responsibility with little perceived control over their environments.

So in both instances, these are the workers who are either at the very bottom of the pecking order or stuck somewhere in the middle.  Further studies reveal that it isn’t the CEO’s and company presidents who have heart attacks and strokes; it’s these other folks who feel unimportant, unappreciated, and unheard.  While company executives work long hours and carry the burdens of entire organizations, the one thing that they have is a sense of control; and it seems that this perceived control is what becomes one of the greatest guards against the effects of chronic stress.

The link between coronary heart disease and back pain still needs to be made in the literature, but I’m putting my money on chronic tension and local ischemic effects.  Imagine that you had an immaculate, white rug imported from an exotic country.  You love this floor covering and ensure its pristine appearance by having everyone remove his or her shoes prior to entering the house.  The kids can’t play on it, the pets don’t go near it, and you clean it weekly.  Now, let’s say that your spouse’s boss comes to dinner.  He is a powerful and important man with a somewhat erratic temperament, the head of a large organization with the ability to make or break anyone’s career.  He doesn’t like to be told what to do and he is at your home to interview your spouse for the opportunity of a lifetime; more money than you can imagine, first class travel around the globe, and free schooling for your children at any university in the world.  Ah, but there is one catch.  He hates taking off his shoes. It is the height of “mud season” and you left your prized rug on the floor to make a good impression.  Upon entering your home he walks across the floor, leaving wet footprints on the tile.  As he approaches that thing which you adore and have dedicated hours to protect, your heart climbs upwards in your chest; and as he obliviously steps across the threshold of your sanity, your throat squeezes shut to stop the cries of anguish.  You watch helplessly as his ponderous bulk grinds layer upon layer of smelly, dark muck into this tapestry de amore.  You feel dizzy and have trouble focusing on anything else for the rest of the evening as you run the cleaning scenarios in your head over dinner and through dessert.  Your recollection of the night is fuzzy at best except for two things, the molestation of your beautiful rug and your spouse’s boss telling him that he didn’t get the job.

Obviously inner conflict causes tension.  When we go to work every day, do the best we can, and still feel like we don’t matter, resentment and animosity brew into deep-seated tension.  This tension constricts blood flow to the whole body; but the areas most affected are the single walled capillaries that feed nerves, muscle, and intervertebral disks.  Tension day after day starves these vital areas of both fresh oxygen and nutrients as well as creates a build up of poisonous metabolic waste products.  The accumulated waste products cause an inflammatory response via histamine mechanisms among other things.  Histamines are of course those things that make your sinus’ swell when you have a cold; so you might imagine what they can do at the local level, creating further stagnation.  This cycle of constriction and stagnation continues to close off circulation and attract white blood cells for cleanup.  Unfortunately it becomes like a traffic jam of emergency vehicles and more congestion results.  Over time this process subjects target areas to chronic blood shortages, whether it’s the heart muscles or the nerves around the spine.

So in short, reviewing our initial paragraph, poor promotion prospects and blocked careers become poor circulation and blocked arteries.  When we feel handcuffed by our life’s circumstances, tension and conflict become our reality.  Of course then our reality becomes our physiology.  I know deeply that every single person, regardless of his or her past experience, has the innate capacity to heal and live an exceptionally healthy life.  Realize this too, shake off the shackles and take control of your life.

-Brian Trzaskos, IRQTC