Stress of a psychological or emotional nature can produce marked changes in the musculo-skeletal system, profoundly influencing the overall functioning of the body. All emotional changes are mirrored in the soft tissues. Attitudes such as anger or fear, as well as moods such as excitement or depression produce muscular postures and patterns. There is also a close link between habitual posture and psychological attitudes and states.
Many postures and defensive tensions arise from anxiety and stress. If this is continued and repeated, restrictions and alterations will take place in the soft tissues. If unreleased these become self-perpetuating and the source of pain and of more stress. The ability to relax is frequently lost and the consequent drain on nervous energy is marked.
The unique understanding which osteopathy brings to the way in which the body functions helps to clarify the manner in which stresses can produce quite different effects in different people.
Have you ever focused sunlight through a magnifying glass to obtain a pinpoint of heat? If, in this metaphor, stress, in all its myriad forms, is represented by the light of the sun, then the focusing mechanism (the lens) is represented by the nervous system. Our attention must be on both aspects of this phenomenon, the stress factors, and how to avoid or minimize them, and the body systems which deal with stress, and in particular the nervous system, which to a large extent determines how the body will cope with it. No two people react to stress in the same way. Even under identical conditions, reactions and effects will vary. While it is important to know what stress is, and how the body reacts to it in general, more attention should be applied to the individual receiving the stress, the unique characteristics of whom will determine the end result.
Why does one person develop an ulcer, another diabetes and yet another high blood pressure? All these conditions might be the apparent result of similar stress patterns. It is obvious, therefore, that the stress factors do not themselves determine the response of the body. The unique make up and history of the individual is the determining factor in deciding just what aspects of the body will adapt or react in response to any stimulus or stress. Disease in the final analysis is the failure, on the part of the body, to adapt to, or cope with, the demands placed upon it by the total environment in which it lives. This includes demands of a stressful nature, whether internally generated or externally applied.
The ‘Fight or Flight’ Response
Stress is a word which is glibly used and which is often misused. It does not in fact have a single meaning, for it can encompass any real or potential stimulus, usually (but not always), of a noxious or unpleasant nature, to which the body or mind is subjected. This might include such varied factors as intense heat or cold, negative emotional states, inadequate nutrition, excessive noise, fear, drugs, pollution, pain, etc. Much stress is exogenous, that is it comes from outside the body, but it may often be endogenous, i.e. it is self-generated (hate, envy, fear, jealousy etc). Any stress factor can be the apparent cause of the reactions on the part of the mind/body complex of the individual. Such reactions are often described in terms of the ‘fight or flight’ response. This describes the primitive response to danger in which immediate preparation is made by the body to defend itself (fight) or run away (flight). The generally accepted reasoning is that since such responses are often socially unacceptable (it is not done to hit out physically or to run away in most stressful situations) the various physiological responses which accompany arousal to fight or flight become, with repetition, the apparent cause of a great deal of physical and mental ill health. A large number of physical changes take place at times of stress induced arousal. These include: the brain and nervous system becomes intensely active, the pupils of the eyes dilate, there is a slowing of the digestive process (which usually stops) the saliva stops and the mouth becomes dry, muscles tense in preparation for activity and the heart pumps blood harder and faster in anticipation of the extra activity; blood pressure rises; breathing becomes faster, to the point of gasping; hormones such as adrenaline are released into the system, as is glucose (from the liver); sweating commences in response to the need to cool the body etc. All this and more is accomplished in a split second under the direction and control of the nervous system.
If the stress factors are rapidly removed then no harm is done and all the changes are reversed. Equally, if a valid response, of a fight or flight nature, is forthcoming (running away from an angry dog or punching a potential mugger) then the physiological changes will have been used appropriately, and normality will return. Such responses are, however, not appropriate to most modern stress situations (unhappy marriage, financial anxieties, fear of redundancy etc.) and if stress factors are constant, or repeated frequently, and there is no release of the build-up of tension, or adequate rest phase from the physiological changes described, then a variety of symptoms can show themselves, including dizziness, stiff aching muscles; headache; visual problems; hypertension; circulatory and heart problems; breathing difficulties, including asthma; allergies; palpitations; digestive disorders, including ulcers; swallowing difficulties; blood sugar irregularities (high or low); backache; skin disorders; bowel disorders (constipation or colitis); sexual difficulties etc.
All these can result from other causes, of course, but often appear when there is prolonged exposure to stress. Noxious stress factors often fall into categories such as difficult personal relationships; excessive pressure due to deadlines and time factors; financial anxiety; inability to communicate deeply held feelings or resentment; personality problems (self doubt etc.), inability to focus and live in present time (the future or past dominate); dramatic life style changes etc.
Stress is not always noxious, or unpleasant but, as defined by modern clinicians, includes many apparently pleasant events, and is now seen to include almost anything, good or bad, which alters the status quo. An outstanding personal achievement, for example, is seen to create as much stress as a change in responsibility at work. A holiday such as Christmas is seen as being equally stressful to the receiving of a parking ticket. Change, itself, is seen as requiring a response, or adaptive change, on the part of the individual, and this is regarded as stressful. Much stress is indeed health enhancing and life enriching, and, indeed, without a degree of arousal we would be cabbage-like in our existence.
General Adaptation Syndrome
When stress is prolonged, or repeated frequently, though, a series of changes may begin which are part of what is known as the General Adaptation Syndrome (G.A.S.). Initially the self-regulating mechanisms of the body, which maintain internal balance, or homeostasis, cope adequately with the constant episodes of arousal, with all the changes that these call for. Eventually, after months or years though, the ability of one aspect or another of the body to adapt, or cope adequately, will become impaired. Imbalance and breakdown of internal balance begins, and the exhaustion stage of the G.A.S. takes over from the adaptive stage. This is when unpleasant symptoms become noticeable. Depending upon the very personal, and unique, attributes of the individual’s physiological and psychological make-up, the way this exhaustion stage manifests itself will vary.
The signs of stress become apparent, and anything from insomnia to asthma, to high blood-pressure, to exhaustion or depression or ulcers may result. If treatment at this stage is aimed at these symptoms then little good can be expected to result. The only real hope is to deal with causes and this involves both the stress factor, and the body and mind, of the individual. This is the holistic concept which permeates ‘natural healing’ in general and osteopathy in particular. If nothing positive is done during the exhaustion phase of the G.A.S. then final breakdown and death will eventually result. If treatment is palliative (drugs etc.), then a similar end-result should be anticipated, although the symptoms might be made more bearable for a while. If, however, the ‘total’ picture is dealt with, there is hope of recovery to optimum health. In dealing with stress all aspects need attention. Primarily the life style of the individual requires an overhaul. How much rest? relaxation? meditation? Is the diet balanced and does it include an adequate amount of vital nutrients? What aspects of the stress problem can be helped by counselling? by psychotherapy? by gaining insights?
It is known that if a ‘stressed’ individual can be placed on an optimum diet and be encouraged to exercise regularly, to take regular and adequate rest, then many ‘diseases’ of stress simply go away. If, at the same time, other aspects of the individual’s life style (attitudes, amount of work undertaken, personality traits etc.) can be modified, then even more improvement can be expected. It is interesting to know that it is quite possible for an aggressive, compulsively hard working, individual to change into a relaxed and carefree one, by the altering of attitudes and behaviour. The statement ‘that’s how I am, I’m afraid’, is meaningless— we can change if it matters enough.
What is it that determines which part of the body will break down under prolonged stress?. There are inherited tendencies of course and this must be borne in mind. There is another key ‘organizer’ within the body, to which the osteopathic profession, in particular, pays much attention. This is the nervous system and the role of spinal dysfunction in affecting the way in which particular patterns of ill-health are manifested. Extensive research in the U.S.A., much of this conducted by Professor Irvin Korr over the past 35 years has established the following:
- That there exists in most people’s spines, areas, or segments, which are abnormal or aberrant in one of (at least) three ways. These areas may be hypersensitive to pressure; restricted in mobility (movement) or asymmetrical (out of position). Such changes are common, even in apparently healthy people.
- These areas are abnormal in the degree of tension or tone that is present in the local soft tissues, and the nerves in such an area respond abnormally to any stimulus. Some of the nerve cells which deal with messages of sensation, or which direct automatic function, or which direct voluntary function, will be in a state of chronic overexcitability. In other words they will react more rapidly and more strongly, and for longer, than they should, to even a mild stimulus of any sort.
- This state of over-reaction is often manifested in the tissues or organs which these nerve cells supply, or control.
These abnormally reacting segments may result from injury, or postural stress, or they may result from problems in a particular organ or system (say a diseased gall bladder) which feeds back ‘irritable’ messages along the nerves supplying it, to the spinal centres, where local irritation may become chronic and cause changes in the tone of the soft tissue. Whether the initial cause is reflex (from the organ to the spinal area) or direct, i.e. biomechanical changes in the spine itself, the result is an over-reacting segment of the nervous system. Since the nervous system organizes the body’s adaptive and protective functions, in dealing with all environmental variations and extremes (changes of temperature, increased activity etc.), as well as its reaction to emotional stress (alarm reaction etc. ), such a state of over-excitability, in a particular area, has enormous local and distant consequences.
Instead of, for example an organ being controlled in a balanced harmonious way, it might be kept in a state of near constant over-(or under-) stimulation, because the nerve centres controlling its function are in this condition. As previously mentioned, such an area is known as a facilitated segment (i.e. it allows easier conduction of nerve impulses and activity). These result in unpredictable effects on the target organ. If such an area occurs in the upper spinal region it might be associated, for example, with heart dysfunction. A definite pattern of spinal lesion has been found in most cases of angina pectoris (severe constricting pain in the chest). If, in a mid-spinal area, then the effect might be on the digestive organs such as the liver or pancreas etc. Now, it must be remembered that although the spinal area is maintaining such over-, or under-, activity via the nervous system, the problem might have originated in the organ itself, for a variety of reasons (infection, toxic state etc. ), and the spinal irritation and consequent facilitated state might originally have resulted from this.
If stress is part of the individual’s life, then the presence in the spine of such areas, and they are the rule rather than the exception, will cause over-reaction, in a chronic manner and the end result will be that the target organ or system will become abnormal in its function. In the fullness of time this, unchecked, will result in damage and dysfunction of the affected organ and disturbance of the entire body economy.
Osteopathic methods enable practitioners to speedily identify such ‘facilitated’ or lesioned segments, Osteopathic manipulation of the spine and soft tissues (e.g. neuro-muscular technique) can often normalize these areas, but in chronic cases only limited improvement may be possible.
All controllable factors in, and around, any ill person should be the concern of whoever is treating them. This should take account of the whole life style and personality of the individual. After balancing the obvious factors (sleep, relaxation, exercise, diet, etc. ) there still remains the normalizing of the biomechanical component of the body, the musculo-skeletal system in general and the spine in particular. Stress can be seen in this light to cause, and perpetuate, dysfunction and disease, in direct proportion to the individual’s unique make-up, both mental and physical. Osteopathy presents the opportunity to intervene by helping to normalize the very structures which ‘organize’ the effects of stress on the body. This, together with counselling regarding emotional stress, and encouragement towards correct diet, and relaxation and meditation exercises, will help to minimize the effect of stress, and provide a comprehensive, non-drug approach, to this universal problem.