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The COVID-19 pandemic and lockdown has had a psychological, as well as physical impact on everyone as daily routines and livelihoods have been significantly affected. Stress, anxiety and depression have increased due to insecurity, loneliness and a loss of control. These emotional stresses may impact us physically, often resulting in back and neck pain as symptoms. However, there are various ways in which we can better manage emotional stresses, as well as their subsequent physical symptoms.

Psychological wellbeing

According to Prof. Ina Rothmann of Afriforte, the commercial arm of the WorkWell Research Unit within the Faculty of Economic and Management Sciences at North-West University in Potchefstroom, “The psychological impact of the COVID-19 pandemic is associated with a type of anxiety condition called the Pre-traumatic Stress Disorder (Pre-TSD).” This syndrome differs slightly from the day-to-day stress that people generally experienced before lockdown. “Pre-TSD is a syndrome involving involuntary, intrusive images and flash-forwards of haunting events that could be experienced because of a major disruption such as the COVID-19 pandemic,” states Prof. Rothmann.

According to Prof. Rothmann, a recent survey of SA employees indicated that the main concerns propelling Pre-TSD in the current environment, are as follows:

• The country’s economy and ability to recover from the pandemic (76%)
• Childcare and schooling (64%)
• Family health and wellbeing (61%)
• Future career possibilities (60%)
• Providing for my family (57%)
• Food security (56%)
• Pay-cuts (55%)

The results from a random sample of 1656 South African employees, between 15 May and 15 June 2020, showed that 74% of employees experience Pre-TSD symptoms on a regular basis. Only 31% of employees were at high risk of stress-related illness pre-COVID-19, however, 46% of the sample are now in the high-risk category. Prof. Rothmann states that these individuals “are at higher risk of developing mental health issues that need treatment in the future.”

Prof. Rothmann also warns against the globally emerging fatalistic tendency around the COVID-19. “People stating, ‘If I get it, I get it and if I die, it is my time’ is a genuinely concerning trend and a destructive coping strategy, putting the global society at risk. Fatalism, in its essence, never solved a problem; it just contributed to more problems. The pandemic has a mental effect on all of us and our experiences are normal. Avoiding how we feel, and surrendering to fatalism and cynicism, is not the way to handle the effects of this pandemic.”

Emotional support

Prof. Rothman advises the following to cope with stress during this time:

1. Recognise that feeling fearful and experiencing a loss of control is normal, especially during a disruptive situation. Also recognise that the situation is only temporary.
2. Reframe your thoughts. You may be afraid, but you have survived hardships before. Shift your thoughts from worse-case scenarios to best-case scenarios and don’t lose hope.
3. Take action and make plans even if they’re small plans. For example, take initiative and be creative to improve your financial circumstances with entrepreneurial ventures, or downscale your living standards until circumstances improve.
4. Reach out for support, but also provide support to others, including children, by listening and recognising their concerns and helping them to reframe their thoughts.

Prof. Rothmann also strongly advises to sustain your medication and treatment guidelines if you are struggling with depression or other mental illnesses and to seek help immediately from your healthcare provider if you feel that you are not coping. You could also contact the South African Depression and Anxiety Group (SADAG) for emotional support at 011 234 4837.

Physical wellbeing: back and neck

Pre-TSD may not only manifests as psychological, but may result in physical symptoms, such as muscular aches and pains. Back and neck pain, in particular, during lockdown may also be due to being less active than usual, as well as home workstations not being ergonomically conducive to sitting for extended periods of time.

Besides emotional stresses and lack of activity, some causes of back and neck pain include:

• Lower back strain
• Arthritis
• Degenerative disc disease
• Improper spine alignment and stability
• Herniated disc
• Spinal stenosis
• Fractures
• Overuse or repetitive strain injuries

Wilma Erasmus from Physio Focus, a Bestmed physiotherapy service provider, states that while back and neck pain symptoms are not the same in all cases, they should be treated with priority and care. “Back pain can range from a mild, dull, annoying ache, to persistent, severe, disabling pain. It can restrict mobility and interfere with normal functioning and quality of life.”

Neck pain occurs in the cervical vertebrae in your neck. Because of its location and range of motion, your neck may be left unprotected and might be more susceptible to injury or overload.

“Pain or discomfort in your back or neck area can be experienced in different ways. It can come on suddenly and intensely, or it can be chronic and might last anything from a couple of weeks to years. The symptoms can be continuous or intermittent,” she added.

Back and neck support

Here are a few stretching tips that you can use at home to alleviate pain while in lockdown:

Chair pigeon pose

1. While seated in a chair, place both feet flat on the floor.
2. Bring your right knee up to your chest and hug it tightly.
3. At a 90-degree angle, cross your right leg over your left leg.
4. To avoid putting pressure on the knee, keep your foot flexed.
5. Repeat on the other side.

Seated twist

1. Sit sideways on a chair, pressing your left hip into the back of the chair.
2. Align your feet and knees.
3. Inhale and lift up through the spine towards the ceiling.
4. Turn to face the back of the chair and hold on to the chair back with your right hand.
5. Press your left palm against the other side.
6. Repeat on the other side.

You should always consult your healthcare provider if you have persistent pain. For recurring or more acute back and neck pain, Bestmed offers a back and neck preventative programme to assist members with chronic back and neck pain, and to improve the clinical state of the back and/or neck in order to prevent surgery.

Bestmed has enlisted Documentation Based Care (DBC) and Workability as contracted service providers for the programme. These qualified service providers apply tested principles including analysis, correction and maintenance of the correct body posture, as well as stabilisation of the spine.

All members are entitled to this benefit, provided they meet the entry criteria. To be considered for the programme, a member must visit a DBC clinic or Workability clinic for an evaluation/first assessment to determine their clinical profile and to ensure that they will benefit from the programme. If the member is considered to qualify for the programme, the doctor will provide a motivation. The member can then send the application to Bestmed for authorisation and inclusion in the programme.