How to Manage Stress Back Pain

Unwind the Pain: The Science Behind How Stress Triggers Muscle Tension and How to Reverse It

Chronic back pain doesn’t always start in the spine—it often starts in the mind.

I know, surprising. Because it’s summer, and I’m a business owner, naturally I have been holding onto stress. I could FEEL my body tightening up the last two months. One morning I woke up with back pain, for the first time ever. I ran through everything I did the day before to determine what I had done to contribute to this specific pain coming from my lower back. Nothing.

When we experience stress, the body reacts instantly. The sympathetic nervous system (fight-or-flight mode) kicks in, causing muscle contraction, restricted blood flow, shallow breathing, and heightened pain sensitivity. Over time, this creates tightness in key areas like the hips, shoulders, and lower back—leading to dysfunction and pain, even in the absence of injury.

Let’s break down how this happens—and what science-backed modalities can help reverse the cycle.

Stress triggers the body’s “fight or flight” response, causing muscles to tense—especially in the shoulders, neck, hips, and lower back—as a form of unconscious bracing. Over time, this chronic tension restricts blood flow, reduces oxygen delivery to tissues, and compresses nerves, leading to stiffness, inflammation, and pain. In the lower back, tightened hip flexors and glutes can alter spinal alignment and limit mobility, creating a structural imbalance that compounds discomfort. Even in the absence of injury, stress-induced muscle guarding can result in persistent back pain that doesn’t respond to typical rest or physical therapy—because the root cause is neurological, not mechanical.

I recently was talking to another business owner about how tight my hips have been and back pain. His response, “I think that’s just part of being a business owner.”

But, I don’t have time for that, even if that’s just part of being a business owner. And if the root of my pain is in the mind and nervous system, I need to incorporate habits that mitigate long term stress and muscle tension.

1. Light, Consistent Movement

Why it works:

Movement is essential for nervous system regulation and tissue health. Chronic stress causes the brain to perceive movement as a threat, resulting in motor inhibition and stiffness—especially in the psoas, glutes, and spinal erectors.

Gentle movement counters this by:

• Stimulating mechanoreceptors, which override pain signals (gate control theory)

• Improving blood flow and lymphatic drainage, which reduces inflammation and stiffness

• Encouraging neuroplasticity—the brain relearns that movement is safe

Example interventions:

• Daily 30-minute walks, ideally outside to promote vagal tone via sunlight and nature exposure

• Mobility drills, especially for hips, hamstrings, and thoracic spine

• Breath-linked yoga (e.g., cat-cow, pigeon, child’s pose) to synchronize parasympathetic activation with gentle stretching

2. Contrast Therapy (Sauna + Cold Plunge)

Why it works:

Contrast therapy alternates between vasodilation (heat) and vasoconstriction (cold), which:

• Improves circulation to tight, ischemic tissues

• Promotes vascular flexibility and nitric oxide production

• Reduces muscle soreness and inflammatory cytokines (e.g., IL-6, TNF-α)

• Enhances endorphin and dopamine release, both of which reduce pain perception

Cold exposure also activates brown adipose tissue and boosts mitochondrial density, which enhances metabolic and nervous system resilience.

Recommended protocol:

• 15–20 min in a sauna (180–200°F) → 2–5 min cold plunge (40–50°F)

• Repeat 2–3 rounds, 3–4x/week

• Finish cold if you want to reduce inflammation and stimulate alertness

I have been doing three 60 minute sessions a week. My specific muscle tightness and back pain has responded extremely well to the heat, so I don’t ALWAYS incorporate the cold and intermittently sit in the sauna for 20 minutes being mindful to include light movement and yoga during my session.

3. NAD+ for Cellular Repair and Nervous System Recovery

Why it works:

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme involved in mitochondrial energy production, DNA repair, and sirtuin activation—all of which are crucial for healing.

Chronic stress and aging both deplete NAD+, leading to:

• Mitochondrial dysfunction

• Impaired muscle recovery

• Greater sensitivity to oxidative stress

Restoring NAD+ through injections or IV therapy helps:

• Improve cellular energy production (ATP)

• Enhance neuroplasticity and neuroprotection

• Reduce oxidative stress that contributes to chronic pain

NAD+ also indirectly supports muscle repair and nerve regeneration, particularly when combined with antioxidants like glutathione.

My personal protocol has been to do five 200 mg within a week. I’ve had success in the past resolving muscle tension and nerve pain when I address the pain aggressively.

4. Weighted Vest Walks

Why it works:

Using a weighted vest (10–25 lbs) adds proprioceptive input and core engagement during walking. This stimulates deep stabilizing muscles, improving postural integrity and muscle balance.

Weighted movement:

• Activates glute medius, transverse abdominis, and spinal erectors

• Increases bone density and muscle endurance

• Enhances neuro-muscular feedback, reducing dysfunctional movement patterns often associated with back pain

This kind of gentle resistance helps the body re-pattern away from stress-based postures (like rounded shoulders or anterior pelvic tilt) and into stronger, more aligned movement.

These weighted walks have become a non-negotiable for me. In addition to the other modalities, this one I’ll keep for the long haul to mitigate any future pain or muscle tension.

5. Yoga and Nervous System Regulation

Why it works:

Yoga isn't just stretching—it integrates movement, breath, and mindfulness to regulate the autonomic nervous system. Slow, deliberate movement with controlled breath activates the parasympathetic (rest and digest) branch, reducing stress hormones and muscle guarding.

Scientific effects of yoga include:

• Increased GABA levels (an inhibitory neurotransmitter that reduces anxiety and muscle tension)

• Reduced cortisol and systemic inflammation

• Improved vagal tone, which enhances resilience to stress

Poses that target hip flexors, hamstrings, and spine help counteract common tension spots tied to prolonged sitting and emotional bracing.

6. Breathwork, Myofascial Release, and Somatic Tools

Why it works:

Muscles don’t tighten in isolation—they follow patterns wired by the nervous system. Breathwork and body-based therapies help retrain the body to feel safe, releasing stored tension and trauma.

• Slow exhales increase heart rate variability (HRV), improving nervous system adaptability

• Myofascial release (foam rolling, trigger point tools, or manual therapy) breaks up adhesions and reduces tonic muscle activity

• Somatic tracking and body scanning restore interoception (body awareness), which often decreases with chronic stress or trauma

This approach is critical for long-term relief because it addresses the origin of muscle tension—your nervous system’s perception of safety.

7. Massage Therapy to Release Stored Tension

Why it works:

Massage is more than a luxury—it’s a therapeutic tool that directly addresses both the physiological and neurological roots of stress-related pain. Chronic stress causes muscle fibers to stay in a state of semi-contraction, creating “knots” or adhesions in the fascia (the connective tissue surrounding muscles). Over time, this contributes to decreased mobility, nerve compression, and pain—especially in the back, neck, and hips.

Massage therapy helps by:

• Increasing circulation and oxygenation of tense tissues

• Stimulating the parasympathetic nervous system, lowering heart rate and cortisol levels

• Breaking up fascial adhesions, restoring range of motion and mobility

• Triggering the release of endorphins and serotonin, natural pain-relieving and mood-lifting chemicals

Deep tissue, myofascial release, trigger point therapy, and even gentle lymphatic massage can all be effective—especially when combined with movement and breathwork to lock in the gains.

I love Amber who works at The Lounge. She is one of the most intuitive massage therapists I’ve worked with, and she pays close attention to how your body is responding.

If you're dealing with back pain that doesn't seem to have a clear physical cause—or that lingers despite stretching and rest—it may be time to look upstream at the nervous system and stress load.

You don’t have to live in pain. The body is capable of healing—sometimes it just needs to be reminded that it’s safe to relax.

I’d also encourage you to seek guidance from providers and trainers in town to slowly restore your mobility. I like Hunter at Hunter’s Garage Gym, he focuses specifically on your nervous system, breathwork, and movement. I also like Josh and Becca at Boretide Chiropractic, they will focus on light intention and exercises to get you back to full movement.