Can stress increase our sensitivity to pain?
Stress. Billed as the health epidemic of the 21st century, stress is the new ‘normal’ state of being. But did you know that stress and the way that we feel pain are closely connected? Bodyset physiotherapist James Bainbridge examines what stress is and explains how it can manifest in pain.
What is stress?
Stress is a human reaction to social or environmental experiences which are perceived as overwhelming, creating a stress response in the brain which is sent to the body.
Why do we get stressed?
Experiences which can cause stress can be broken down into four categories, also known as N.U.T.S.
- Novelty. An event or emotion which you have not experienced before. For example, beginning a brand–new task at work or having a first child.
- Unpredictability. An experience you were unprepared for and/or have little time to prepare for. For example, a big task that has been dropped on you at work with an urgent deadline.
- Threat to the ego. Someone or something is challenging you as a person. For example, someone questions your methods of performing a task or tries to physically intimidate you.
- Sense of control. An experience which makes you feel out of control. For example, you or someone you love has an illness or injury which you feel unable to do anything about.
What happens when we get stressed?
Once the brain perceives the experience as overwhelming, a process of physical changes begins. This process is commonly known as the ‘fight or flight’ response. Firstly, the brain activates the body’s sympathetic nervous system. This nervous system is responsible for initiating releases of a variety of hormones including cortisol. These result in physiological changes in the body including; a faster heart rate, raised blood pressure, increased breathing rate, higher blood sugar levels, and more muscle tension. Over a short period of time, for example if there is a threat of attack, these physical responses can be beneficial for our safety.
Modern-day life and stress
Although these physical responses to stress help us in the case of short-term, intense threats, factors which cause us stress in modern-day life are likely to be prolonged and harder to cope with. For example, whereas our ancestors may have spent ten minutes out-running predators, we may spend two weeks out-running deadlines.
A prolonged stressful experience causes a continued hormonal release. Over time, this extended state of stress can result in a series of physiological changes. Alarmingly, this can then lead to a variety of health problems such as heart disease, diabetes, depression and anxiety.
To begin with, it’s worth exploring what we understand by the term ‘pain’. The current definition, according to the International Association for the Study of Pain, is that “Pain is a distressing experience associated with actual or potential tissue damage with sensory, emotional, cognitive and social components”.
There are undeniably distinct similarities between the definition of stress and that of pain. Both are ‘feelings’ which are the result of experiences and how we perceive those experiences. Both can be expected and unexpected, new and persistent. Finally, both can make us feel like we have no control.
What is the link between stress and pain?
There is a clear link between the brain and the nervous system in both stress and pain. In the stress ‘fight or flight’ response, messages are sent from the brain to the nervous system and then back to the brain. In cases of pain, messages go from the nervous system to the brain and are sent back to the nervous system. During pain and stressful experiences, similar parts of the brain are stimulated. In fact, stress can even increase your sensitivity to pain. How? Stress causes your muscles to tense or spasm, increasing your sensitivity to pain. It also causes the levels of cortisol (your body’s main stress hormone) to rise which can cause and increase inflammation. Considering all of these factors together, it’s clear that it is essential to consider stress as a key factor in pain, especially in persistent cases.
How can we combat stress?
To address stress, we need to understand what areas of your life are causing you to feel this way. A medical practitioner or physiotherapist may ask about lifestyle factors including work, travel, sporting or other interests and your current mood. Reducing stress alone is unlikely to relieve you of pain completely. However, it can be vital for improving the impact of pain on your mood, sleep and ability to perform at work.
Tips for relieving stress
- Recognise the issue. Unless you acknowledge your stress, you’re going to find it hard to do anything about it. Think about your daily tasks and ask yourself; are any of them driving you N.U.T.S?
- Review your lifestyle. Really reflect on what you are doing and whether you are managing yourself to your best ability. Making small changes can really help.
- Exercise. Find an exercise you enjoy and make realistic goals to get active frequently.
- Use your support network. Speak to the people close to you about your feelings and consult your boss too if you feel this would help.
- Seek help with physical symptoms. Regular massage, physiotherapy and acupuncture can help with side effects of stress, such as feelings of muscle tension.