The Link Between Elevated Cortisol, Stress, and Chronic Back Pain: How Sports Massage Can Help

The Link Between Elevated Cortisol, Stress, and Chronic Back Pain: How Sports Massage Can Help

Cortisol – the ‘stress hormone’, released by the brain as part of the ‘fight or flight’ response and plays a critical role in helping your body cope with a stressor. In the short term, this is beneficial: it prepares muscles for action, increases blood sugar, enhances brain function, and suppresses non-essential functions like digestion to prioritize immediate survival.

However, prolonged periods of psychological and physical stress keep cortisol levels elevated, which can have a detrimental effect on the body, particularly the musculoskeletal system. Pain-induced stress responses communicate to our body that the pain we experience is dangerous and threatening, continuing the cycle of cortisol release from the HPA-axis and the subsequent continuation of the effect on the neuromuscular system. The muscles remain in a contracted, shortened state, and when muscles are continuously tense, they begin to restrict our range of movement and contribute to the development of poor postures. This presents itself as the persistent discomfort and pain we see in areas such as the lower back, shoulders, and neck. Over time, this can lead to the development of chronic pain conditions like tension headaches, sciatica, and lumbar pain.

How Sports Massage Can Help

Sports massage is an effective method used to treat muscle tightness and pain. During a sports massage, targeted pressure is applied to restricted areas using deep tissue massage and myofascial release techniques, helping to restore muscle length and improve circulation. Assisted stretching, mobilisation and dry needling are additional techniques I use to improve range of motion and flexibility.

Sports massage activates an important bodily system that brings us out of ‘fight or flight’ mode – called the parasympathetic nervous system (PNS), or the "rest and digest" system, which helps the body relax and lower cortisol levels. This shift in the nervous system activation allows the muscles to relax, release tension and the body to restore its intended state of balance.

Importantly, sports massage promotes the body’s natural healing process, encouraging the release of endorphins, the body’s natural painkillers, which further contribute to pain relief and muscle relaxation. Regular massage sessions can be hugely beneficial in managing pain and enhancing recovery, with research supporting the reduction in cortisol levels from massage therapy. Aside from the physiological benefits, it allows the nervous system to shift from the chaotic, over-active state to a calmer, more balanced state of being. Above all, I have found that by offering the chance for people to just stop, rest, and switch-off for an hour to be a key factor in their recovery or wellness journey.

References

Villafane et al., (2020). Exploring the Relationship Between Chronic Pain and Cortisol Levels in Subjects with Osteoarthritis: Results from a Systematic Review of the Literature. Osteoarthritis and Cartilage, 28(5). 570-80. https://doi.org/10.1016/j.joca.2020.02.836

Hannibal, K., Bishop, M. (2014). Chronic Stress, Cortisol Dysfunction, and Pain: A Psych-neuroendocrine Rationale for Stress Management in Pain Rehabilitation. Physical Therapy, 94(12). 1816-25. doi: 10.2522/ptj.20130597

Davis, H., Alabed, S., & Chico, A, J, T. (2020). Effect of Sports Massage on Performance and Recovery: A Systematic Review and Meta-Analysis. BMJ Open Sport Exercise Medicine, 6(1). doi: 10.1136/bmjsem-2019-000