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)

·         LOW BACK PAIN!!!

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!

-Dr. Gangemi