Can prolonged stress affect your pain and healing? Research now suggests that it can, particularly with chronic pain. If you suffer from ongoing pain you may have noticed this relationship yourself. Many people know that their pain is worse when they are stressed but they don't know why.
Stress activates your sympathetic nervous system, this is the where we can move into "fight, flight or freeze" mode. The sympathetic nervous system is responsible for keeping us safe when we are in danger, however it can be activated for prolonged periods and many of us lack the skills to return control to our parasympathetic nervous system, which is responsible for helping us to "rest and digest".
How would this affect pain?
During this state muscles become tense and ready for action, the nervous system is extra sensitive to stimulus, blood pressure is raised and we are more likely to notice and have negative thoughts. Tense muscles can become tired and sore or put extra stress on other structures, causing pain and irritation. Often when in a stressed state our breathing becomes shallow and rapid, even when not really exerting ourselves, such as while sitting in an office.
Use your breathing to recover.
An effective way to help your body return control to the parasympathetic nervous system is to consciously change your breathing. One method is to hold your breath for as long as you can, once you relieve your breath your body senses that a threat has passed and can return to a more relaxed state.
Another commonly used technique is box breathing. To do this, breathe in for four seconds, hold for four, breathe out for four, hold again for four and repeat. Do this for a few minutes until you start to feel more relaxed and calm.
Show your body that you are safe.
Other activities that can help your body to relax include yoga, going for a swim or having a shower, or doing some intense exercise where your heart rate is raised.
Speak to your physiotherapist for more information on this topic and tips to help you relax during the day.
The benefits of keeping active may seem obvious, yet it can't hurt to be reminded of the many ways exercise can improve your life. Here are a few of our favourite reasons to get moving...
1. Exercise improves energy levels.
Improving your fitness means your body is capable of achieving more for the same energy expenditure. While doing exercise can make you tired in the short term, regular improvements to your fitness will help you get more out of your body each day, with seemingly less effort.
2. Exercise can help to reduce stress.
If you are stuck in a state of stress or anxiety, exercise can help you move out of it into a calmer and more relaxed state, improving your mood, concentration and sleep. There are now many studies to support this.
3. Exercise and hobbies can help you build connections and community.
Making new friends as an adult can be surprisingly difficult and the importance of connection and community is being recognised more and more as being essential for overall wellbeing. Being part of a team, group or club is a great way to build confidence and meet friends as well as keeping active.
4. Exercise keeps your muscles, tendons, joints and bones healthy.
Our bodies are often compared to machinery or car parts. However, there are some crucial differences between our bodies and machines, including the fact that our bodies respond to exercise by becoming stronger and healthier, rather than being worn out. As an example, one of the best ways to prevent osteoporosis is through regular high impact activity, which stimulates bone growth.
5. Exercise can help to reduce injuries.
Similar to the previous point, tissues that are used regularly are stronger, more elastic and are less likely to tear or break when under stress. Regular exercise is the best way to keep your body in a healthy state and prevent injuries.
Finding the right exercise for you can be tricky, your physiotherapist can help you with suggestions based on your ability and skillset if you need some help.
A common fear for people when discussing pain is the idea that their symptoms are 'all in their head' or that they won't be believed by friends, family, therapists or workmates. This fear can be worse when there appears to be no obvious or visible cause for their pain or if it has been present for a long time.
What is pain?
Many of the models used in the past to explain pain lead us to believe that the intensity of pain will always be proportional to the severity of an injury. The experience of pain is always real and usually distressing. However, pain is a warning system used by our nervous system to alert us to danger, not a direct indicator of damage done. This is an important distinction, meaning that the experience of pain can be influenced by many different factors and not exclusively tissue damage.
How can stress impact pain?
Part of the role of your nervous system is to sort through a huge amount of sensory input and interpret it in a meaningful way. When pain is considered to be a serious threat to the body, the intensity of the pain will be worse.
This can happen in many situations, such as...
-The source of the pain is not well understood, leading to fear that the pain might be something very serious;
-The nervous system is in a state of hyper-arousal, such as when you are stressed or tired;
-The pain or injury has a significant impact on your quality of life, work, relationships or hobbies; or
-The injury occurred through a traumatic event such as a car accident.
What does this mean for my treatment?
Along with more traditional treatments, we also know that stress reduction strategies, mindfulness and addressing any emotional trauma associated with pain can all help to aid recovery and improve quality of life. Your physiotherapist is a great person to speak to about pain management strategies so you can get the most out of your life while dealing with your pain and injury.
Most tissues in the body have healed completely in six to 12 weeks following an injury. However, many people have severe pain that lasts much longer than this. We know that the intensity of the pain you feel is not always associated with a corresponding amount of actual tissue damage. In some cases, there can be a severe amount of pain with almost no detectable damage. With this in mind, we explore some reasons why your pain might not be getting better, long after the tissues have healed.
You’re afraid of the pain?
Pain can mean many different things, for some of us pain can affect our ability to work or can be a symptom of a serious disease. What you believe about your pain can either amplify or reduce the symptoms you experience. If you feel that every time you experience pain you are causing more damage, you will naturally pay more attention to this and your nervous system will amplify the signals in an attempt to keep you safe.
But if you understand the cause of your pain and know that while there is discomfort, you are not in danger of causing more damage, often the pain will feel less severe. This is one of the benefits of seeing a physiotherapist after your injury as they can help you to understand your pain, giving you more control over your recovery.
You started moving differently after the injury?
Immediately after an injury, it’s natural to change the way you move to avoid painful movements. After a while, these changed movement patterns can become a problem and actually begin to cause pain and discomfort on their own due to the altered stress patterns placed on your body.
Correcting these adaptive movement patterns can often go a long way in reducing pain after an injury. You might not have noticed these changes and might need a physiotherapist to identify and help you to return to your usual movement pattern.
You have lost muscle strength since the injury?
While a certain amount of rest following an injury is helpful, if we stop moving altogether our muscles will lose strength. This can mean that our posture changes, we fatigue easier during our normal activities and we are more susceptible to further injury. Less movement also means we actually focus on the pain more when it does happen. Physiotherapists are able to advise you on the right types and amounts of exercise for you in the period following your injury.
The pain has affected your lifestyle?
When pain affects your ability to sleep, work and even concentrate, it’s not surprising that this can have a negative affect on your overall well-being and mental health. This can create a negative cycle of anxiety and depression that perpetuates and increases the experience of pain. If your pain is really getting you down, speaking to a mental health professional can actually be a valuable part of your physical recovery.
Many other factors can obviously contribute to your neck pain not getting better, but these are four examples we commonly see. Contact your health professional for help with any persistent pain you may be experiencing.