The Stress–Pain Connection: How Reducing Stress Can Reduce Pain

Are you in pain? If you are stressed — whether about the pain or something else entirely — you could be making it worse.

Doctors have long suspected that there is a clear connection between pain and stress, both in the sense that stress causes pain, and that stress influences our ability to manage pain. Stress can cause pain by increasing muscle tension, particularly in the neck, shoulders, and back. Almost everyone has experienced this type of discomfort, which is often relieved when the stress subsides, or through the aid of stretching, massage, or pain medication.

While stress-induced pain is common, and generally easily managed, doctors are also interested in how stress influences the brain’s ability to handle and process pain impulses. One of the brain’s primary functions is to reduce pain impulses. Because pain is unpleasant, the brain automatically tries to reduce those feelings and allow the body to continue to function.

However, stress inhibits the brain’s ability to perform this task. Stress hormones interfere with the normal functions of the nervous system, increasing both the intensity and duration of pain.

Recent research from the University of Montreal supports this theory. In a landmark study released in 2013, researchers found that stress plays a major role in the ability to manage chronic pain. The study examined 16 people who have chronic back pain, and 18 people without pain as a control group, and found that almost across the board, the patients with pain had higher than normal levels of cortisol, also known as the stress hormone. In addition, many of the patients with pain also had a smaller than average hippocampus, which is associated with higher cortisol levels — and therefore, increased chronic pain.

Stress Relief = Pain Relief?

Because there is such a strong connection between pain and stress, it seems that a simple solution would be to get rid of stress. Well, as everyone knows, that’s just about impossible. Modern life is filled with potential stressors, not to mention the fact that pain itself can lead to stress. In some cases, this leads people living with pain to reach for medication or undergo surgery in an attempt to alleviate pain, but there are a growing number of providers, including American Pain Treatment (http://www.americanpaintreatment.com), turning to alternative methods of reducing and controlling pain.

The key isn’t necessarily to eliminate stress from your life (although removing or reducing as much as possible is never a bad idea) but learning new techniques for managing stress. While we may not be able to control everything that happens in our lives, we can control our responses to stressful situations. Taking time to relax, or performing exercises designed to calm the mind and reduce the physical effects of stress, such as high blood pressure and heart rate, tension, and irregular breathing, can lower stress hormones and reduce pain. Some of the ways that doctors recommend reducing stress include:

• Engaging in hobbies. Doing something you enjoy, such as reading or gardening, can counteract the harmful effects of stress by refocusing your energies and creating feelings of well-being.
• Laughing. Studies show that not only does laughing help you relieve stress by releasing “happiness” hormones, it can also relieve pain. There is strong evidence that a good laugh can interrupt the pain-spasm cycle in muscular disorders.
• Get social. Spending time with a good friend or your family remind you that you have a support system — and it helps if you can laugh and have fun with them!
• Breathing exercises. Being mindful of your breathing helps control the shallow, rapid breaths that often come with stress. Focusing on taking long, deep breaths takes your mind off the stress temporarily, and allows you to refocus and respond to the stress.
• Meditation. Taking 20-30 minutes to be mindful of your breathing, without focusing on thoughts or pain, will relax you, and reduce your stress. Guided imagery is another useful form of relaxation; imagining a scene where you feel happy, relaxed, and content for five to 10 minutes can help you reduce stress and pain.

Because everyone’s response to stress and level of pain is different, not all relaxation techniques work for everyone. Don’t be stressed if you try one and it does nothing for you. Just try another until you find the coping technique — or combination of techniques — that works for you. Working with a trained professional with experience in pain management through psychotherapy is also helpful, as he or she can guide you to the right technique.

So the next time that someone says that your pain is “all in your head,” you can respond that they are at least partially correct. However, learning to control stress’s effects on your brain can help reduce your pain, and improve your overall health.