Chronic stress and pain
Are you feeling stressed or anxious, and have ongoing aches and pains? Not necessarily enough to make you seek out treatment, but they have been making sleep uncomfortable for you, giving you a stiff neck and shoulders, and starting to prevent you from doing the things you love?
- Neck and shoulder pain
- Abdominal cramps/pain
- Sore jaw
- Leg cramps, particularly at night
- Tight muscles that won’t relax
- Unexplained injuries, pain
These can all be caused by chronic stress. When we’re stressed, our bodies go through a familiar pattern of response, called the “stress response”. Initially, as the brain recognises a stressful situation, it sends a signal to the adrenal glands to release adrenaline into the bloodstream. As the adrenaline flows through our body, it causes physiological changes – our heart rate goes up, pushing more blood to the muscles; we take extra oxygen into our lungs; sight, hearing, and our other senses become sharper; and our blood pressure rises.
After the initial surge of adrenaline which has ramped up our “fight or flight” response, the adrenal glands will then release cortisol. During the stress response cortisol acts to increase blood sugar availability and provide more energy for the brain, as well as allowing for tissue repair by being anti-inflammatory, and reducing the function of non-essential bodily functions eg. digestion, growth, and reproduction.
How stress affects pain
The stress response is designed to be short lived, and is only meant to activate while in a stressful situation. But when we are feeling under constant stress from work pressure, family commitments, or just a busy lifestyle with not enough down time, the stress response can stay on all the time (Hannibal & Bishop, 2014). This leads to cortisol being released for far longer than it was designed to be, which over time, and through a number of different mechanisms, means your cortisol stores become depleted. As cortisol has an anti-inflammatory effect on your body, when we are deficient in it, this leads to increased inflammation, leading to pain (Hannibal & Bishop, 2014).
Chronic stress-induced hypocortisolism (reduced cortisol in the body) has been linked to a number of chronic pain conditions:
- Chronic Fatigue Syndrome
- Chronic pelvic pain
- Temperomandibular joint (TMJ) dysfunction
- Morning fatigue and pain
- Lower back pain
- Leg pain
- Unexplained, recent onset musculoskeletal pain
So as can be seen, ongoing stress can be a factor in chronic pain, whether by initiating or exacerbating pain symptoms, impairing healing, or prolonging the pain experience. It is therefore necessary to deal with both aspects if you feel that stress may be a part of your experience of pain. Acupuncture has been shown to be effective in both reducing stress and anxiety, as well as in the treatment of chronic pain.
Amorim, D., Amado, J., Brito, I., Fiuza, S.M., Amorim, N., Costeira, C. & Machado, J. (2018). Acupuncture and electroacupuncture for anxiety disorders: A systematic review of the clinical research. Complementary Therapies in Clinical Practice, 31, 31-37.
Ayada, C., Toru, U. & Korkut, Y. (2015). The relationship of stress and blood pressure effectors. Hippokratia, 19 (2), 99-108.
Hannibal, K. & Bishop, M. (2014). Chronic Stress, Cortisol Dysfunction, and Pain: A Psychoneuroendocrine Rationale for Stress Management in Pain Rehabilitation. Physical Therapy, 94 (12), 1816-1825.
Harvard Health Publishing (2018). Understanding the Stress Response. [Online] Available at: https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response
MacPherson, H., Vertosick, E., Foster, N., Lewith, G., Linde, K., Sherman, K., Witt, C. & Vickers, A. (2017). The persistence of the effects of acupuncture after a course of treatment: a meta-analysis of patients with chronic pain. Pain, 158 (5), 784-793.
Mayo Clinic (2016). Chronic Stress Puts Your Health at Risk. [Online] Available at: https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20046037