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Lower Back Pain and Your Adrenal Glands – A Common Connection

by drgangemi on December 12, 2008

Lower back pain is the most common cause of job-related disability and the leading contributor to missed work. It is second to headaches in the realm of neurological disorders. The lower back may be painful due to a bulging disc, an injured/pulled muscle, arthritis, or even a problem from elsewhere in the body – such as the foot or knee, referring pain to the lower back.  Just in the United States alone, low back pain suffers spend over 50 billion dollars a year diagnosing this pain via X-Ray, CT scans, MRIs, and other studies, and then treating this pain thru either natural methods such as chiropractic or acupuncture, or more extreme methods via painkillers, anti-inflammatory medications, and surgery. There are many reasons for low back pain, too many to discuss in just one article, but a very common and overlooked problem resulting in lower back pain is that of adrenal gland stress.

Your adrenal glands are those little walnut-sized endocrine glands that sit on top of your kidneys. And for being so little they pack quite a punch. Most think of them when it comes to adrenalin, as this is where it is made, however they are also responsible for the production of cortisol, (to help balance blood sugar and fight inflammation), sex hormones, (DHEA, testosterone, estrogen, progesterone), and aldosterone, which is needed to balance electrolytes (sodium-potassium) in the body. Your adrenal glands are your first line of defense when it comes to stress. Under stress, cortisol levels are secreted in massive amounts, and DHEA, sometimes referred to as the longevity hormone, is suppressed. Over prolonged periods of stress your adrenals can become so fatigued that they will make very little of the hormones intended. The medical authority doesn’t recognize the adrenal glands from a functional standpoint – only from a pathological perspective. Addison’s Disease is when the production of the hormones has ceased and Cushing’s Syndrome is diagnosed when cortisol levels are extremely elevated. However, many people have a functional adrenal gland problem, meaning their hormones are not working optimally. Basically, if a person is under stress, the adrenal glands will be affected; though this is not always a bad thing as it is a natural and actually healthy response to make stress hormones when under stress. However, under heavy amounts and prolonged stress, the adrenal glands will suffer. If you’re thinking that most everybody has some sort of adrenal gland stress, you’re absolutely correct.

Since the adrenal glands are the first to react to stress, they are often the first of the endocrine glands to wear down. Prolonged stress will often result in insulin problems as the pancreas and adrenals share the workload to balance blood sugar levels. This will result in blood sugar handling problems and over time, even Type II Diabetes. A thyroid disorder will often be the secondary problem of adrenal gland stress, even though in society it is often thought of as the primary problem after discovered following some routine blood work, and there are numerous pharmaceuticals to address the thyroid readily available. Low testosterone levels in men and low progesterone levels in women often accompany further adrenal gland stress, leading to a low sex-drive, weight gain, and PMS in women

Your adrenal glands will give you warning signs that they are under stress long before they give up on you. Here are some common signs and symptoms that your adrenal glands are stressed:

  • Bright lights bother your eyes (need to wear sunglasses even on a cloudy day)
  • You get dizzy when you stand up or change positions quickly
  • Headaches across the forehead, over or behind the eyes
  • Your eyelids twitch
  • Your body jumps or twitches as you’re falling asleep
  • Tired feet at the end of the day or pain in the heel (plantar fasciitis)

The muscles supporting much of the lower back (as well as the feet & knees) are related to the adrenal glands. The hamstrings, which span the back of the pelvis down past the knee, the gracilis, commonly known as the “groin” muscle attaching to the inside of the pelvis, and the sartorius, which is the longest muscle in the body going from the top of the pelvis down and across to the inside of the knee, all are related to the adrenal glands and provide major support to the pelvis and lower back. When the adrenal glands are under more stress than they can handle, whether from lack of sleep, a poor diet (too much caffeine, for example), emotional or physical stress, or various other issues, these muscles will directly be affected and the support to the lower back will be lost. Once the muscles no longer support the area, you’re a prime candidate for an easy injury as the normal biomechanics are lost. If you ever wonder why someone suddenly “throws their back out” or wakes up with a mysterious low back ache, often it is because of an adrenal gland problem. The muscle imbalances are often there long before the symptoms occur, with few exceptions such as with a traumatic injury.

Since many of these adrenal-type muscles connect the pelvis to the knee, you can see why knee and inner thigh problems are also very often adrenal related. The two most common I see are groin pulls and medial meniscus and/or medial collateral (MCL) tears. This is because the three main muscles that attach to just below the inside of the knee all have a strong relationship with the adrenal glands. So when these muscles don’t do their job, the meniscus and MCL have a massive amount of stress put on them. Additionally, the pelvis will torque, the sacrum will misalign, and you’re an accident waiting to happen.

The muscles of the calf and feet are also related to the adrenal glands. Those tired feet, shin splints, plantar fasciitis, and burning claves are often due to adrenal gland fatigue. These muscle support the normal arch of the foot, and that allows a person to naturally pronate when they walk/run. Pronation is very important – it is the primary way your body absorbs shock upon impact. If the muscles are fatigued, the arch will weaken and pronation will be lost. Once the foot cannot pronate correctly, the stress of impact will be transferred up to the knee and ultimately the lower back.

A healthy lifestyle will keep your adrenal glands strong and working efficiently throughout your life. Resolving physical/structural problems, correcting nutritional imbalances with supplements and dietary changes, and dealing with emotional/mental problems are all equally part of the adrenal gland triad of health. However, if you sleep a few hours a night, eat a lot of refined foods, drink a lot of coffee, don’t exercise, and are under chronic emotional stress then your back is gonna let you know!


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  1. First mate permalink

    Wow, you nailed it. “Low back pain and adrenal gland”. I didn’t realize these symptoms are related all these years! Where were you when I needed your help? Yes, I am overstressed with two jobs (one state job and one part time job). Yes, I am menopause and it is not quite under control. I’ve had constant bladder infections and tried a variety of antibiotics (including Cipro that intensify my leg muscle spasms; and IV therapy). My urologist is dumping me after exhausting all options. Today I will see an infectious disease doctor and I’ve been told not to hold my hopes on him. It is frustrating and I feel I am out of control with my body. I really need help to get this under control. Do you know of a doctor you trust in California or should I see you?

  2. Angela permalink

    Ok. I have all but two of the symptoms you listed above (no body twitching or eyelids unless I’m nervous). Plus some additional ones. I also have Idiopathic Thrombocytosis (high platelets, not too high though…just 450-480 average) & my joints hurt sometimes. I’m wondering what exactly do I need to do to make my adrenal glands healthy again. I read about the two week diet for CI & the Paleo diet & some different tests that could be done. I’m confused though about what to do first and then second. Also, I think I read on your site somewhere that there’s a way to jumpstart the adrenals again? If so, would you do this only after doing whatever’s needed to make the glands healthy again or do it before? Thank you for any help!

    • Hi Angela, I can only give exact, specific advice to patients, either in person or via phone. Check out the Office tab for more info; thanks!

  3. Marge permalink

    This article is so helpful! Have had horrible time w SI joint for twelve yrs now. Threes yrs ago had adrenal gland removed. Had benign tumor. Today area of adrenal glands burns! Been exhausted lately! Eat well! Do yoga! Been to physical therapy for lower back. Do exercises every day. Not sure what else to do??

  4. Michelle Duran permalink

    Great article! It explained a lot to me re the relationship of the adrenal glands to the rest of the body. Very informative.

  5. Sheena Miller permalink

    Wow. This is a “slap my forehead” moment. I even have a small growth on my left adrenal gland that showed up on a CT for something else, determined to be benign. I’ve been drinking a lot of extra coffee for months, treated with many things for low back pain, twisted my foot and in a boot for 4 weeks, headache across the forehead, was on low-dose steroids for awhile for Lupus. What blood tests would be abnormal with adrenal gland problems? Thank you.

    • Typically none unless your adrenal glands are to the point of exhaustion in which case electrolyte imbalances may show up in blood work – sodium, chloride, potassium. Check out the Adrenal Panel from Diagnos-Techs which I discuss here:

  6. bitap permalink

    i have low tolarance to light n anxiety from some years.nie i have back pain n prostattis,it seems my adrenalin glands have can i contact you,i m ib india

  7. Jerah permalink

    I have pain on my right side near my belly button when I press the area. I watched a video demonstrating how to locate your adrenal glands and what it means if there is pain. The area is showed is exactly where I feel the pain. I have a very intense workout routine as well as a generally stressful life. Last year my left adrenal gland was removed do to a pheochromocytoma. I have been feeling many of the fatigue symptoms and now I am concerned that I’ve damaged my good adrenal gland. I cannot afford to injure my remaining gland and I would like to know the best way about healing it and protecting it? Thank you for any answers and advice.

    • That’s all about monitor and dealing with stress of every type in your life – diet, exercise, emotional & physical stress, etc.

  8. lisa permalink

    everyone of those on your list is on my list; i have screws in my neck bulging disks beneath; bulging disks in my low back in all but one disk a few to a danger zone; and of course my insurance wants to start out like always do with dumb injections that are a bandaid if even that…(a bandaid from the dollar tree store)
    i was wondering cuz of all the numbness I feel if there is corelation between my back injuries and sexual feelings…even when i force myself when my guy forces it.

    • Sure there can be a link between the two. Not just that but any pain will result in sexual problems to some extent since the pain will affect your nervous system and your hormones.

  9. Been There permalink

    This comment for “First Mate”. I had similar symptoms – UTI pain but negative tests for bacteria, repeated antibiotics obviously didn’t help, but AZO helped with pain. Turns out my internal muscles in the pelvic floor were so tense they wouldn’t relax. I found a clinic specifically for women’s urinary problems with a fantastic physical therapist. Athena Urology in Issaquah, WA. Maybe they can refer you to someone local?
    PS: I was told to stop all kegels and meditate twice a day instead.

  10. veronicah permalink

    all of the above= to me.I went to a reflexologist and when she worked on my adrenal gland i felt pain and she said it was stress.I have to start taking care of myself.Thanks

  11. I have been diagnosed with first, Addison’s Disease and more recently, Hashimoto’s disease. I have had 2 back surgeries for ruptured discs at L4, L5 and a laminectomy in that area. Now, it looks like I may have SI Joint Dysfunction and I am awaiting results from an MRI which may or may not show anything. What can I do to help myself besides the physical therapy and exercises I am currently doing? I had no idea these things may be related until Friday when my physical therapist said the pain pathways have changed, the tingling in the right leg has increased, etc. Are there natural supplements I can take/use to assist? I am working full-time as a teacher and in a great deal of pain, I walk with a cane but, I love my job. LOVE my job. I do not want to leave a career I worked so hard to get into, have a family to support and I love what I do.

    • I suggest you find a holistic doc such as a chiropractor, naturopath, acupuncturist, or even medical doc who can help you sort out those health issues.

  12. Joyful permalink

    So I got my blood work back and I am 50 very low testosterone and progesterone and high potassium 5.6. I have headaches, eye lid twitching back ache mainly in the morning. Do you think my adrenal glands may be causing this?

  13. Morena permalink

    Good day drgangemi

    I have this problem of when I get really upset I immediately get painful throbbing waist pains and right across my spinal cord. for the pain to tone down I have to calm down first and it only last for about a minute or two but those few minute with that throbbing pain scares me to bits

    I think adrenaline rush does that to me but why? please can you assist if possible it has been happening for almost 5 years now



  14. Nick permalink

    This makes sense and describes a large part of what happened to me. The logic is sound but I’m still unclear about how the AG can influence the muscles in the area. How can hormonal inputs in the brain have localized, rather than system-wide, consequences… Do you have any hypothesis about that? Thanks!

    • They do have systemic-wide effects no doubt but certain clinicians have made a correlation between muscles of the hips, knee, and feet with the adrenal glands.

  15. Whitney Walker permalink

    I have struggled with many illnesses for many and doctors are still trying to figure more out. Lately, my bloodwork has shown low cortisol in AM and PM and low ACTH. I am hyperthyroid right now. My levels won’t change until this adrenal thing is under control. I have had sweats so bad and heart palpitations and my blood pressure goes up periodically. Have you heard of any of this before? I am seeing an Endo in a week but have had all the problems you discussed for probably a year and on top of that low WBC. I have lost so much weight in the past and now gained 14 pounds in a couple months in weird places.

    • You should consider a consult with a doctor who understands how all these system interact with one another; though perhaps your endo doc has that experience.

  16. RunningGal permalink

    Dear Doc,

    I have been diagnosed with a burnt out adrenal gland and under active thryroid. I am taking hormone medicine for this. I have been on the meds for 1 month and do not feel any better yet (experiencing all the symptoms of dysfunctional adrenal and thyroid glands). The problem is that I have entered and Ultra in the next couple of weeks which I am continuing to train for. Obviously the deficiencies I am experiencing is negatively affecting my training and in return creating fear for the ultra. Kindly advise what is the best course of action – rest or continue training. Does this condition pose a health risk for the ultra? Also, how long does it take for the hormone production to restore to normal?

    Thank you

    • Simply put – you should not be training for an ultra if you have burnt out adrenal glands. Check out all the info on the Sock Doc site regarding this.

  17. Angela permalink

    Hi, I’ve had Hashimotos for 3 years an thought that I have not ever had it under control, the past 3 years have been a nightmare. I have extremely low cortisol levels low blood pressure, extreme body aches an muscle mass loss, have had extrensive abdominal tests for pain including ct ‘ MRI, colonoscopy, gastroscope all unveiling nothing. Have had MRI on brain to rule out anything causing these awful headaches. I suffer lower back an leg pain an am awaiting surgery for 2 bulging discs in my back. My Dr is. Ow thinking maydbe Addison’s disease an thinking my pituitary gland as well. I have severe bouts of diarrhea an nausea as well. Do you feel my Dr is on the right track. Am feeling like I’m banging my head on closed doors as it seems to be taking forever to get sorted. Thank you

    • I’d suggest you get a second opinion and happy to set up a Skype consult with you too if you’d like.

  18. Hello. I had a CT scan done for other reasons and 3-4 cm incidentoloma was found on my left adrenal gland. It is non-functioning but the surgeon has recommended I have it removed. What are your thoughts around having what is likely to be a benign mass removed for the sake of removing it – and is it possible for a non-functioning mass to still result in other adrenal dysfunctions like low sodium, fatigue, vertigo, low sex-drive, etc…

    I’m torn between having the surgery simply because there’s no way to know if it’s cancerous until you remove it – and not doing it b/c of the risks, cost and fear of the added stress that one gland would endure and the impact that may have on my body (i.e. hormone imbalances)

  19. I suppose I should also add that I’ve been undergoing cranio sacral treatments for vertigo over the last few weeks while training for a half marathon. I see a vestibular disorder specialist tomorrow but am not sure if there’s any connection with the adrenal mass and the vertigo. It seems to be compression-related due to my training.

  20. danielle Norris carmody permalink

    I live in PA. K have chrons and had my colon removed. Ever since my personality has changed ive gained 80 lbs. I cant handle anything. Deoression amd AD have been diagnosed as well. All this after losing my colon and undergoing chemo. My dr. Said thru blood test im hypo thyroid but is concerned about medicating me. I know its my adrenal glands. My bsck the point I had my kidneys checked. Would love to worm with you if you take patients via Skype.

  21. Martin Castaldi permalink

    Hi Dr. Gangemi I am doing a back pain pamphlet for a project at school. I was wondering if I had permission to use the image of the “back pain is no joke” cartoon in my project.

    -thank you,
    Marty Castaldi

  22. Elizabeth permalink

    My specific situation.
    LOTS of stress- too many close deaths in my family this year—- ok so I got thin but then I have ALWAYS been tired since. Stopped being vegan and started eating meat again (not a beef eater really- hated chicken but now eating this and lamb, pork or fish mostly- sushi)

    SHOOTING PAINS THROUGH MY KNEES: Noticing this when I have eaten sugar or had carbs that take longer to break down.

    DIGESTION: Always constipated and MUST exercise with cardio or my body becomes sluggish to digest and I pass out very easily.

    Scared I am headed to be like my father with Diabetes. LOOD TYPE?

    Is there TRUTH to this book and theory? I am a type O Negative/ Postive (not sure which but definitely O Blood type.

    PLEASE direct me with answers Dr. Thank you in advance!

  23. Great article, thank you. But aside from the few points in the last paragraph is there anything else to do?
    We have a good diet, get plenty of sleep and don’t even drink coffee or soda, but still have severe bouts of “my back went out” and almost all of the other symptoms you mentioned?

  24. Lisa permalink

    Hi Dr Gangemi.
    Just like to take the time to thank you

  25. Lisa permalink

    I have a great natural path that has put me on the right supplements, I see a chiropractor every 2 weeks, I’m a big fan of energy healing which has been great with my anxiety. And of course yoga has help with my low back pain. I do try to exercise daily but limit it to 30min. Up till now I would of said I’m on the recovery but the sudden death of my father in law has put me back square one again and it feels like all that train has gone out the window! The positive side is it isn’t lasting as long. I think One thing I remember is that this didn’t happen over night it has taken a long time to get like this so it will take time to get back to my normal self. My advice stay strong don’t play the victim and fight like anything to get yourself health and happy again.

  26. Mrs. B permalink

    Hello. I would just like to know if adrenal disorder causes hypothyroidism, or the other way around. Also, I have read that using fibroids are related. How do I know which is the primary issue from which everything else is stemming? Thank you.

    • Sometimes it’s hard to figure out what is primary, secondary, etc… All hormones affect one another. Fibroids (uterine) are typically due to estrogen dominance.

  27. Jewels permalink

    Do you see patients for Cushings? And if I do a Skype consult, can you order a CT scan or MRI at my local hospital along with additional lab work you may need?

    • I do and can help with natural therapies but it would be your medical physician who would order those diagnostic tests.

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