Is Stress Affecting my Pain?
Our understanding of the relationship between stress and pain has evolved exponentially over recent years, thereby helping to expand our knowledge of what pain is and how it’s caused. The more we learn about stress, the clearer it becomes that our stress levels dramatically affect our pain and in some cases, may even be the cause.
What is Stress?
So, what do we mean by stress? There are lots of different definitions for the term stress, it could be argued that everything is a potential stressor on the body, from weight training to emotional anxiety and everything in between. However, for the purpose of this blog, we will be discussing the consequences of stress on the body, or the ‘stress response’. This is often termed the ‘fight or flight’ response, where the body releases certain hormones as part of a survival mechanism. This stress response can be triggered by pretty much anything that feels stressful to us and can persist for a short or long period of time.
How does it Work? - the sciency bit.
In common with a lot of things to do with the human body, no one knows for sure, however, the mechanism by which stress is linked to pain tends to revolve around a thing called the Hypothalamic Pituitary Adrenal axis, or HPA for short, and the Hypothalamic Gondal Axis, or HGA for short. The idea is that when you get stressed or anxious, your body releases hormones from the parts of the brain like the amygdala, this in turn causes adrenaline (a fight or flight hormone) to be released from the adrenal glands. To regain hormonal balance, cortisol (a type of steroid) is also released, which does some really useful stuff like decreasing inflammation (anyone who has a hydrocortisone injection will know this!) However, there is a down side to this too. The release of lots of cortisol, especially over a long period of time can actually start to increase inflammation and pain instead. This mechanism probably contributes to why short and long-term anxiety and stress have been shown to cause increased sensitivity to pain. In other words, things that should cause little or no physical pain can actually become very painful in the presence of stress. This can explain why simple activities such as bending forwards can become very painful for back pain sufferers, even when no damage has been shown in the back on x-rays or scans. The bigger problem is that this pain stops us moving as we don’t want it to hurt and as we move less we become stiffer, which causes the pain to get worse, sound familiar? If this goes on long enough, the brain can actually learn that bending is painful, so the activity remains painful long after any damage has healed.
Evidence for recovery and coping mechanisms
So, what can be done? There are a few really interesting avenues to explore if you are suffering from anxiety and pain. One of the main ones is exercise and movement. When we exercise, the body undergoes a phenomenon known as exercise induced hypoalgesia (EIH), which basically means that enjoyable exercise and movement can really help reduce both pain and stress. Further to this are stress relaxation techniques such as mindfulness meditation, which has been shown to reduce pain when practised for as little as 5-10 minutes a day!