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3 remarkable ways stress can make pain worse

Let's look at how the brain handles stress

Our brain and nervous system are designed to protect us and help us to survive

In chronic pain (long term/ongoing), information from our body goes to the brain. The body collates all the evidence and information based on previous experience, understanding, beliefs, emotional state, movement, information from our senses and makes a decision as to whether there’s pain, and if so, what level and type.

The longer term the pain is, the more relevant these other factors are to the pain experience.

There’s also a factor of misunderstandings of the nervous system, for example, where there is no tissue damage but the interpretation received in the brain is not entirely accurate. For example, when someone has an amputation they can experience phantom pain. This is an experience of pain where the body part has been entirely removed and there are no tissues to receive a pain message from.

Example case

pain

Somebody arrives in Accident and Emergency and their symptoms very much resemble a heart attack. Upon further enquiry and investigation, it was identified as a panic attack.

What has happened here?

Let us say the person has a phobia of enclosed spaces and they get into a lift or subway and a large group of people also get in. Their previous experiences, perceptions, and thoughts activate their survival physiology, their heart rate speeds up, breathing quickens, they sweat and tremble, they experience tingling and nausea and possibly chest pain.

So, what started out as an experience, linked to thoughts and perceptions soon becomes a huge physical reaction.

The autonomic nervous system responds to our thoughts, experiences, beliefs, values, culture and trauma. You may have heard of this as the Fight, Flight, Freeze response or, the Rest, Digest and Recovery response.

Example case 2

You visit your doctor with headaches (or our headache specialist Katie North). They identify a lot of head, neck, shoulder and jaw tension and suggest stress as the cause. You think about your life recently and conclude this makes sense as you have been under a lot of stress recently. We very much accept the notion that stress can cause a tension headache but do not so readily accept it’s involvement in other areas such as the back.

In fact, evidence shows that anger and more so repressed anger can cause a strong contraction of the paraspinal muscles of the back too.

anger

What other feelings can put our body into fight/flight?

Anxiety, worry, repressed anger, fear. Not only do our experiences affect our body, but so do our personality and thoughts. People pleasers, those who feel they are not good enough, and perfectionists, for example, can all influence our physiology and pain.

If our stress, thoughts and experiences can affect our body, so can a whole host of trauma, such as:

These can all put the nervous system on red alert. This can sustain a constant protective fight, flight, freeze physiology. This constant state is difficult for the body to run all the time and can lead to fatigue, digestive problems and pain.

So, there we have three remarkable ways in which stress can have a huge impact on your physical health and increase the day to day pain you may feel.

By David Brown, Occupational Therapist and Movement specialist

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