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Stress and Its Relationship with Chronic Pain

Updated: Jun 13, 2023

Woman in a state of stress and in pain
Woman stress and in pain

A lot of my clients don't generally associate their pain with stress, but most of them live very hectic and stressful lives. Who doesn't these days? So lets look at why they are related as once we gain awareness of what is going on we can start to heal.

Our nervous system plays a crucial role in how we experience and manage pain, specifically the sympathetic and parasympathetic nervous systems. While both of these systems are part of the autonomic nervous system (the part of the nervous system that regulates involuntary bodily functions) and they play very different roles.

The sympathetic nervous system (SNS) is responsible for the "fight or flight" response we experience when we encounter a stressful or threatening situation. When this system is activated, our heart rate increases, our breathing becomes faster and shallower, and our muscles tense up in preparation for action. Think back to the caveman days of having to hunt and survive whilst being chased by a saber tooth tiger! Luckily we no longer experience situations that look like that, but the way we live out lives put our SNS under the same type of stress and it can cause physical symptoms like anxiety and muscle tension.

The parasympathetic nervous system (PNS), on the other hand, is responsible for the "rest and digest" response that helps us relax and recover from stress. When this system is activated, our heart rate slows down, our breathing becomes deeper and more regular, and our muscles relax. This response is important for restoring our bodies to a state of balance and promoting healing. Note - real rest that helps the body heal does not include sitting on the sofa watching tv with a glass of wine, no judgement here - I am guilting of this many times over, but here we are still being stimulated by what we are watching, alcohol consumption and most of the time we also have a mobile phone in our other hand.

So how do these two systems relate to chronic pain?

Well, chronic pain is often associated with a state of persistent stress or inflammation in the body, which can cause the SNS to remain in a constant state of activation, which can lead to ongoing muscle tension and anxiety. Over time, this can create a feedback loop where the pain causes stress, which in turn exacerbates the pain, and so on and so on.

The SNS response involves the release of several chemicals, including adrenaline, noradrenaline, cortisol, dopamine and glucagon. The key chemical here in terms of pain is cortisol. This hormone is released from the adrenal glands and is often referred to as the "stress hormone." It helps to regulate blood sugar levels, blood pressure, and the immune system.

Cortisol has its good points, it has anti-inflammatory properties that can help reduce pain levels. However, when cortisol levels remain high, ie when we constantly lead busy and stressful lives, it can lead to chronic inflammation, which can increase pain levels. Prolonged stress can cause muscle tension and trigger points, which can also contribute to pain.

So, if cortisol levels do not subside after a fight or flight response, it can lead to chronic inflammation and muscle tension, ultimately increasing pain levels in the body.

The parasympathetic nervous system, on the other hand, can help to counteract this cycle by promoting relaxation and reducing inflammation.

How do we heal?

There are many ways in which we can help our bodies to heal and to activate the parasympathetic nervous system.

Listen to your body - this is easier said that done as it involves having to stop, be still, move out of living in our heads and let ourselves drop into our body. This isn't woo woo our bodies are amazing and do hold all the answers but we need to open to listening and asking what are you trying to tell me. Spoiler alert it is maybe telling us to slow down. I have personally experienced this and I thought I was good at resting, obviously not and it took an "accident" where I sliced through my thumb and middle finger and was unable to work for a week. It forced me to slow down and take time to work out what my body was trying to tell me. It was frustrating at first, but when I realised that I had been ignoring what my body and intuition had been telling me my fingers started to heal really quickly.

Use the breath - the easiest way to slow the body down, active the parasympathetic nervous system and to drop out of our mad monkey minds and into the body is to breath. Thankfully we all do it thousands of times per day and its free. Don't give me excuses that you don't have time, everyone has a few minutes and if you say you don't then you definitely need to sit your butt on a supportive chair and start practising.

Sit comfortably with your bank supported and preferably with your feet on the floor. Close the eyes and take a few big inhales in through the nose and exhale out of the mouth with a sigh. Then just breath naturally though the nose bringing your attention to your breath. It may help to say in your mind "breathing in" and "breathing out" in time with the breath. Set a timer on your phone for 3 minutes and notice how you feel before and after. Don't give yourself a hard time if you don't feel anything at first, or if you feel worse as its a practice you may have never done this before. Be kind to yourself, but keep trying, its a great tool to slow things down when we are have a lot on and are in overwhelm.

Gentle Exercise Practices - slow flow yoga, yin yoga, qi gong and a relaxing walk in nature are amazing forms of exercise to ground us and bring us back into our bodies. These techniques can help to calm the mind and body, reduce muscle tension, and promote healing.

Sleep - getting enough good quality sleep is paramount. If you find it hard to sleep you can do a few "rescue breaths" whilst lying in bed. Place your hands on your lower belly and breath in for a count of 5 and out for a count of 5, pausing slightly between the inhale and exhale. On the exhale imagine smiling into your belly.

Remember these things take practice, especially if we aren't use to stopping and resting. Be kind and gentle to yourself. Just start somewhere and build things up little by little, it will become easier especially when we start to feel the benefits.

It's important to note that chronic pain can have many different underlying causes, and there is no one-size-fits-all solution. If you are experiencing long term pain and would like to find out why and identify the root cause then please feel free to get in touch, I would love to work with you to help you heal.

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