Does Stress Affect Chronic Pain?

The nature of the relationship between stress and pain is quite mutual. One heavily feeds into the other, and much of that has to do with how our body and mind process stressful events, and moments of pain. Stress can be described as anything that brings us way out of our intended equilibrium – a knock or blows to one side strong enough to tilt us over, maybe even making us crash.

Pain, on the other hand, is a sensory event. It occurs typically as a warning, our body’s way of communicating to us that something has gone horribly wrong and requires our immediate attention. Pain is a trigger for stress and can bring us way out of our own element. But stress can influence pain, both through analgesia (painkilling) and hyperalgesia (increased sensitivity to pain).

Understanding Chronic Pain

Chronic pain is another matter entirely because it doesn’t function as normal pain does. Most pain is acute and occurs in relation to specific damage or a sudden problem. It occurs due to specific stimuli, or due to a problem within the body itself, like a headache, a stomachache, or organ pain. External examples include a cut, bruises due to trauma, or the searing pain of a burn. Acute pain varies in duration and severity but can be directly linked to a sudden cause.

Chronic pain, however, is pain lasting for at least three months. This type of pain is not in response to a physical problem, but representative of something much more complex. When the body gets injured, we receive pain signals to inform us of that injury. Over time, those signals fade – even if the injury hasn’t completely healed. The pain only returns if the injury is aggravated before it has healed completely. But the body isn’t perfect, sometimes:

• Wounds don’t heal right.
• Nerves are damaged and aren’t repaired as they should be.
• Tissue scars in the wrong way continue to send the body pain signals.
• Lingering psychological trauma can prolong and perpetuate pain that has no reason to exist. Although more than enough time has passed for the body to recover, the pain lingers.

For some people, the pain is a result of an incurable condition, meaning there’s little hope of it ever going away on its own. Because it flies in the face of what pain is meant to do (inform us), chronic pain is also more difficult to assess, diagnose, and treat.

Why Does Stress Matter?

Part of managing and treating chronic pain involves understanding how the patient is caring for themselves, and what they’re going through on a daily basis. Chronic pain often isn’t as simple as addressing a root cause, because the cause may be untreatable, or very complex. Outside of trying to resolve the root issue, a big part of pain management for chronic pain is finding effective ways of numbing the pain, with minimal drawbacks. This is where questions about stress and lifestyle begin to play a big role.

Patients who come to a professional to have their chronic pain assessed and treated may not expect to be asked about how they’re sleeping, what they’ve had for lunch, or how their relationships with others are going. But these are crucial questions to help assess a patient’s stress levels, in order to determine what else can be done to improve their pain levels. The more stressed a person is, the more likely they are to struggle with pain.

These questions can also help screen for specific conditions such as mental health-related disorders. More than just bad thoughts, these mental health issues play a role in how a patient may feel physically. These conditions also affect a person’s appetite, sleeping habits, eating habits, and tendency towards adhering to a self-care regimen – all of which are things that can help reduce pain in cases of chronic pain. Managing your emotional and physical stress is critical for chronic pain.

Reducing Stress and Chronic Pain

Stress can be expressed chemically. We release different chemicals in response to stress, which has a physiological effect – even when the ‘threat’ perceived is purely psychological. Results include an increased heart rate, a jump in body temperature, and the release of specific chemicals in our sweat that trigger anxiety in others. But it doesn’t have to be that visceral – we react to stress in much subtler ways as well, including;

• Changes in behavior, thinking, and mood;
• Hormonal changes that can affect menstruation (in women);
• Physical performance (in men and women).

We’re not just talking about pregame jitters here. Long-term psychological stress, the kind caused by worrying every day, a cascade of unfortunate events, or, more to the point, constant chronic pain, can have a serious impact on mental and physical health – and feed back into the pain, making it seem even worse than it is. Like a vicious cycle, stress caused by pain can make the pain worse, and further give cause to other forms of stress, from anxieties and depressive thoughts to weight gain, a shift in appetite, lack of motivation, problems focusing, abnormally high blood pressure, and more.

It’s critical to manage and reduce stress when dealing with chronic pain. External support here is important – motivation is not just an intrinsic ability, but something that must be nurtured, built, and slowly cultivated, often with the help of others. Healthcare providers, medical professionals, family members, and friends all play a role in helping someone with chronic pain stay motivated in their fight against pain, continuing to seek treatment, following their exercise regimen, sticking to their dietician’s recommended nutritional plan, and more.

Tempering Expectations and Cultivating Gratitude

Stress isn’t easily managed, and some days will certainly be overwhelming. Patients with chronic pain understand that this isn’t something that goes away quickly, but it can still be frustrating to feel like nothing’s ever getting any better. It’s important to see the role that mindset plays in fighting back against pain, by focusing on the positives rather than the negatives. Focus on achieving short-term goals that give you a sense of time moving forward, such as:

• Going from a short five-minute workout to exercising half an hour each day.
• Hitting a specific weight goal
• Achieving a certain level of strength
• Maintaining employment for a year despite certain physical challenges.

By adjusting your expectations, setting realistic goals, working to achieve them, and being grateful for the progress you’ve made, you can avoid the pain and stress that comes with constant doubt.