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Keep Caregiving From Taking a Toll on Your Back

Physical and emotional stress can lead to serious pain for caregivers. Here's how to ease the burden.

By Gina Roberts-Grey | June 12, 2012

As a caregiver, you might expect to face frustration, anxiety or exhaustion. But the chronic stress many caregivers face can also cause back pain or exacerbate pain caused by a previous injury. The intensity of pain can range from constant and dull to intermittently piercing, affecting both your quality of life and your ability to provide care to your loved one.

Comparing a group of caregivers to a group of non-caregivers with a similar physical health profile, a team of researchers in Spain recently found that caregivers reported more emotional stress, and displayed more back pain, weakness and postural strain, even if they did not regularly lift the person they tended.
 
How Caregiving Stress Affects Your Back

Stanford University health psychologist Kelly McGonigal, the author of Yoga for Pain Relief, says that the stress caregivers experience activates the nervous system, both causing pain signals to reach the brain more rapidly and amplifying those signals. "This makes low-level pain you might be able to naturally suppress when you’re not under stress impossible to ignore," she says. The stress-pain cycle is hard to escape. Your body naturally tenses up in stressful situations, McGonigal explains, "and this chronic muscle tension is a major cause of stress-related chronic pain.”

(MORE: 5 Ways to Make Caregiving Tasks Easier)
 
The muscles most likely to tighten up and become sore due to chronic stress are in your back, shoulders and neck. The routines of caregivers contribute to the pain. "Caregivers are often in positions where their back and neck may be stressed because of the necessary bending forward, which places tension on the back and neck,” says Mary Ann Wilmarth, chief of physical therapy at Harvard University Health Services. Signs that you're carrying stress in your back can include muscle tension, tightness and poor flexibility; limited range of motion; and muscle knots, Wilmarth says, adding, “The pain of stress in the back can be an aching, a sharp pain or radiating pain.”
 
The physical changes that occur as a result of aging are a complicating factor as well, she says. "As we age our connective tissue becomes less flexible, making it more difficult to loosen a tight muscle and improve flexibility," Wilmarth says. "Additionally, the discs in between each vertebra lose some of their water content and the vertebrae get closer together."

(MORE: Is Caregiving Making You Sick?)

Smart Strategies for Easing Stress and Protecting Your Back
 
Exercise relaxation. Yoga, meditation and breathing exercises are some of the easiest ways to relieve stress. You don’t have to dedicate a lot of time to these exercises — researchers at the University of New Mexico have found significant reductions in stress levels from as little as one hour a week.
 
Get plenty of rest. Adequate rest is a critical part of managing stress, and for most people, that means about seven to eight hours of sleep a night, says Dr. Jennifer Sohal, a spine surgeon who specializes in middle-aged and older patients at St. Vincent Spine Institute in Los Angeles. Sleep, she says, allows muscles to recover and the discs in your spine to rehydrate.
 
Take breaks. Find time for three 15- to 30-minute breaks each day to decrease the buildup of stress in your spine, advises physical therapist Hayley Murray, owner of Indianapolis in-home care provider ComForcare Senior Services: "Caregivers must have time for themselves to participate in activities they enjoy such as coffee with friends, morning walks, Bible study or exercise."
 
Drink water. When you’re dehydrated, the discs between your vertebrae shrink and the nerves become pinched, increasing your pain, so drink plenty of water to help keep your muscles and discs hydrated.
 
Lift smartly. Always keep the person or object you’re lifting close to your body and lift with your legs, which are stronger than any other part of your body. Keep your back straight and avoid twisting or similar motions that take your body out of alignment or force your feet to pivot.
 
Stretch. Stretching can reduce stress in your back by increasing blood flow to its muscles. "It also gives you the opportunity to focus on your own needs" for a moment, Sohal says.
 
Wilmarth says these stretches can help ease back stress and can be performed anytime throughout the day:

  • Shoulder circles. Gently roll both shoulders backwards 2 to 10 times to release stress in upper back, shoulders and neck.
  • Lower back stretch. While standing, place your hands on your lower back as if you were putting your hands in your back pockets. Gently straighten your back, arching back only as far as is comfortable, and stretch for 5 to 10 seconds. Repeat 2 to 10 times.
  • Knee to chest. Lay on your back and bring one knee to your chest while keeping the other straight. Hold the position for 5 to 10 seconds, then switch legs. Repeat 5 to 10 times for each leg.
Improve your posture. It's important to maintain proper posture while caregiving, to avoid fatigue in the back and neck, says Wilmarth, who shares the following tips:
 
While standing:
  • Evenly distribute your weight on both feet, keeping your head aligned in the middle of your shoulders. Your chin should be in line with your breast bone.
  • Your shoulders should be pulled comfortably back and lined up with your hips, but not to the point of standing at military attention.
  • To adjust your stance when standing for a while, place one foot in front of the other and shift positions frequently. Don’t rock side-to-side.
While sitting:
  • Sit comfortably with your back against your chair and your weight evenly distributed on your hips and tail bone. If necessary, sit slightly forward, but avoid slouching.
  • Just as when you’re standing, keep your head aligned, over your neck, with your chin in line with your breast bone or spine.
  • Hold your shoulders back, not slouched, keeping them centered above your hips.
  • Maintain about a 90-degree angle in your knees — any more than 90 degrees puts stress on your knee joint. If you can’t do this naturally, place a stool or phone book under your feet.
(MORE: Caregiver Depression: Unspoken but Traumatic)

Keep moving. Whatever steps you take to relieve back stress, don't just stop moving altogether. "It's a common misunderstanding that if your back hurts, you should stop moving altogether," Murray says. "In reality, gentle movement is important to recovery." Lack of movement, however, leads to reduced muscle strength and weakened muscle tone which will just lead to more pain.

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