Back pain and heart disease

I’ve long noticed that people with heart disease seem to have stiff backs. I mean literally stiff – inflexible. Coronary arteries (the blood vessels that supply the heart itself) stiffen as they accumulate atheromatous plaques. Stiff arteries… stiff backs. Is there a common cause?

It turns out that there is a fair amount of research to show that people with chronic back pain and “widespread pains” are also at greater risk of coronary artery disease (and some types of cancer). Wow. So, is the back pain, or the lowered levels of physical activity it leads to, or the medication we take for it, leading to an increase in heart disease risk; or do stiff back and stiff arteries (and coronary artery disease) have a common cause? So, does one lead to the other, or do they have the same root causes, which shows up as an “association”, in research terms?

This is an important question to answer.

Last week I attended a day’s course on nutrition and supplementation for cardiovascular health. I don’t have time in writing this to go into the ins and outs of why fat is no longer deemed to be the cause of poor cardiovascular health (I’ll happily give you chapter and verse elsewhere). During the day there was a lot of focus on inflammation and poor connective tissue (more on that below) being big contributors to poor arterial and venous health.

The walls of your blood vessels consist of different layers and rely heavily (as nearly all tissues do) on connective tissue, which in turn is largely made up of protein complexes. The best known and most widespread are collagen and elastin. These proteins provide the framework for all sorts of structures; like bone, cartilage, skin, muscle, blood vessel walls etc. If your health status does not support the formation (and constant renewal) of these proteins, you are likely to have stiff, inflexible tissues, which would result in a stiff inflexible back and coronary blood vessels (some people go the other way and have loose floppy tissues).

Equally, if your tissues are frequently inflamed, which can be caused by a host of factors (that I’ll explore in a subsequent post) those tissues will be damaged and need to repair themselves. By the way, inflammation often leads to pain, which is why some people’s back pains feel better when they take anti-inflammatories. If you have inflamed tissues in your back, why wouldn’t you have inflammation in your coronary arteries too, assuming the causative factors are common. Chronic inflammation (not fat!) is increasingly accepted in the research community as being the leading cause of coronary artery disease.

I am almost certainly not the first clinician to wonder whether there are common causes for persistent back pain and the development of heart disease, but it’s not something I’ve heard others exploring, and a quick google didn’t reveal anything. If you know of anyone thinking/researching on this topic, please be so kind as to send me details!

Meantime, if you have been told you have tight tissues and/or a tight back, don’t panic! Next time you’re in seeing me, let’s explore the bigger picture and not just try to reduce your risks of back pain, but also your risks of more life-threatening problems. Sounds worth exploring, doesn’t it?

Sources and interesting (quite technical!) read:

Musculoskeletal pain is associated with a long-term increased risk of cancer and cardiovascular-related mortality:

Chronic Pain and Mortality: A Systematic Review:

Is Chronic Low Back Pain Associated with the Prevalence of Coronary Heart Disease when Genetic Susceptibility Is Considered? A Co-Twin Control Study of Spanish Twins

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