The COVID-19 pandemic has had a profound impact on every aspect of our society, economy and environment. With health restrictions, strained resources and limited institutional capacities, one unique impact on the 23% of mothers with school-aged children under the age of 15 years in Hong Kong is how their roles have changed - and how the demands on their time and energy have skyrocketed.
The caregiving role of these mothers has transformed from one that has better balance, to one that sees them supporting their children while they learn from home while simultaneously trying to maintain their careers, keep on top of their daily responsibilities, and find time for the things that energise and relax them. Overall, this has resulted in a lingering increased level of stress and fatigue amidst the struggle to balance their domestic, caregiving, social and working responsibilities.
With a strong connection between stress and pain, we’ve been working with many mothers who report the onset of a range of new pains during this time, as well as the exacerbation of their existing musculoskeletal problems that have grown to now be intolerable. Here’s a look into why and how we’re seeing these changes, the true impact of stress on your body, and what you can do from home to help manage the effects on your body.
Stress: The Impact & Sources
While the pandemic has been a great stressor to most people, some of the sources of stress are particularly prevalent in women, including:'
Working From Home
During the pandemic, 66.4% of those forced to work from home lacked the proper equipment to do so, and 65.8% found they were easily distracted by domestic chores, while 63.9% said they were disturbed by family members, children or others who live together. These factors are linked to stress in women as they often take responsibility for the majority share of the domestic and caregiving activities within a household.
Flight Restrictions
As we move into our third year of flight restrictions both here in Hong Kong and internationally, we think of the nannies and in-home support workers who have been unable to fly home or take a break that isn’t filled with concern about when they’ll next be able to see their loved ones. This can not only add a constant level of stress to their lives, but also has amplified the responsibilities and daily duties of many nannies and carers whose workload has increased significantly with school-aged children at home, while also caring for younger pre-school aged kids. This means much more physical strain and demands on their body and time.
Poor Ergonomics
For those working from home, while some had a separate office to work in that was ergonomically optimised, others were setting up at kitchen tables or in already cramped bedrooms. In a survey examining musculoskeletal pain and workstation design, women were found to report significantly greater musculoskeletal pain, especially in the neck, shoulders and lower back, while also having a poorer design of the home workstation, particularly relating to seat height and monitor distance. For women who were not working from home, the added duties involved with supporting their children through online learning such as crouching down to communicate or sitting at small tables and on small chairs added physical stress on their bodies.
Worry And Anxiety
It’s hard to know what to expect during a global health crisis, and what it means for the future of our families - and that creates a lot of potential sources of worry. Mothers may worry about when and if school would go back or be shut down again, be concerned about their children contracting the disease, wonder about the impact of online learning on their child or if their schooling efforts were sufficient, and much more. At a high-level, studies that examined a person’s mental state and psychological disorders during the COVID-19 pandemic overwhelmingly report that the affected individuals show several symptoms of mental trauma, such as emotional distress, depression, stress, mood swings, irritability, insomnia, attention deficit hyperactivity disorder, post-traumatic stress, and anger.
Reduced Incidental Exercise
Working from home under strict lockdowns has the secondary effect of negatively impacting the amount of incidental activity individuals are able to engage in. Normal daily activities such as walking to and from work, walking to meetings or around the office, and playing with children at the park are all eliminated by lockdowns and working from home periods. Not only does a reduction in physical activity impact the body physically, but increased levels of inactivity have been linked to increases in stress and mental health difficulties. Sitting for prolonged periods of time has been found to adversely affect spinal musculoskeletal health, with women being at a higher risk of developing skeletal issues than men due to their lower bone density. Over half of people who sit for long periods of time have reported suffering from neck pain, low back and shoulder pain. Long sitting times have been linked to fatigue, decreased job satisfaction, hypertension, and musculoskeletal disorder symptoms in the shoulders, lower back, thighs, and knees of office workers.
Increased Strain Of Balancing Multiple Roles
Statistically, women on average engage in three times as much unpaid care and domestic work as men. School closures and overburdened health care systems during the pandemic put an additional demand on women to cater to the basic needs of their families and households, leaving many struggling to successfully balance the competing demands for their energy and time. Emerging evidence from UN women’s rapid gender assessment survey also indicates that the disproportionate share of unpaid care work during the pandemic increased, constraining a working mothers’ ability to manage their paid work.
Self-Care & Enjoyment
Aside from domestic roles, the nature of lockdowns and the pandemic may also see reduced time for women to spend on self-care, intentional exercise, maintaining friendship, social interactions and relationships that require quality time, and the activities they enjoy. With less time available, needing to stay home with kids, and a hesitancy to attend social functions due to infection risk, many women are spending less time on the activities they enjoy.
Stress On Physical Health
The impact stress has on the body is well documented. Long-term stress leads to a build-up of inflammation in the body, decreased immunity, musculoskeletal pain, and increased sensitivity to pain. In our patients, this has been manifesting heavily as unbearable neck pain and mid-back pain. When our bodies experience a high level of anxiety or stress, its natural reaction is to tense up. This is because during stressful events, cortisol and adrenaline are released which trigger an involuntary tightening of the muscles, typically in the neck, shoulders and down the spine. When this happens consistently over a long period - like during a lengthy pandemic - it can lead to muscle tension, stiffness, tightness, aches and pains in the neck, back and surrounding areas. This can be accompanied by tension headaches, and the effects of stress can also amplify the pain. Research examining people suffering from neck pain has shown that those who were in distress as a result of anxiety and depression had the worst neck pain that lasted longer, and were less likely to be active in their own recovery.
Treating Stress To Resolve Pain
We are working extensively with mothers, expecting mothers, as well as nannies and support caregivers, helping them manage a wide range of stress-related pains, aches and tension that is extending much further than back or neck pain. Once we establish the effects of stress in the development of your pain, we can form an effective treatment plan to begin your recovery. This often looks at other contributors of pain - like postural problems and the tendency to regularly crouch down to the height of children, pick up after them, sit on low chairs to help with schooling and more. We offer both in-person appointments for assessment, diagnosis and recovery plans, as well as telehealth consultations to help our clients start their recovery at home by coaching them on everything from postural control and ergonomics, to core strengthening for back pain, to how to use rollers, bands or household materials like chairs and broomsticks for stretching and helping their back and neck muscle tension. To book your appointment with our fantastic team, call us on +852 2801.4801 or book your appointment online.
References
- https://www.bycensus2016.gov.hk/en/Snapshot-04.html
- https://pubmed.ncbi.nlm.nih.gov/28900385/
- https://pubmed.ncbi.nlm.nih.gov/33263142/
- https://www.ln.edu.hk/sgs/news/survey-findings-on-working-from-home-under-covid19
- https://interactive.unwomen.org/multimedia/explainer/covid19/en/index.html
- https://pubmed.ncbi.nlm.nih.gov/35095004/
- https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-020-00589-w
- https://pubmed.ncbi.nlm.nih.gov/33312136/
- https://pubmed.ncbi.nlm.nih.gov/29730619/
- https://pubmed.ncbi.nlm.nih.gov/12830370/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5618737/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2568977/
- https://pubmed.ncbi.nlm.nih.gov/24798553/
- https://pubmed.ncbi.nlm.nih.gov/12815874/
- https://pubmed.ncbi.nlm.nih.gov/30586593/
- https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/1471-2474-10-13
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4395677/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465761/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4637917/