Stress: A Trigger for Pain?

Why does everyone tell me that my pain is exacerbated by stress?  How is that possible?

I have often wondered this as a therapist as well.  We see it here in the clinic; many times patients have the potential to flare up when they are in stressful situations or a stressful time in their life. We see that stress can be a trigger to a longer period of pain/discomfort for patients depending on what their diagnoses are.  My thoughts always go to the analogy “ is it the chicken or the egg?”  Meaning this: is the discomfort the patient experiencing causing them mental stress or is stress triggering these symptoms?

We know that the mind-body relationship is very powerful.  Here at 5 Point Physical Therapy we try to embody both and teach our clients the best ways to manage.

So how can stress affect some systems in the body?

Stress Related Issues in Nervous System

Part of the nervous system, called the autonomic nervous system has a direct role in response to stress.  When the body is stressed, it sends out the “fight or flight” response and the body signals specific glands to release hormones.  These hormones cause heart to beat fast, increased breathing, increase blood flow, and digestive process chances.  When the body is chronically stressed, there can be a long term drain on the body and even wear and tear!

Stress Related Issues in Musculoskeletal System

When the body is stressed, muscles tend to react by tensing up and then release their tension when stress passes.  This is how our body guards against injury and pain.   However, when there is chronic stress, the muscles in the body are in more of a chronic state of guardedness.  The muscles are then tight and tense for longer periods of time and promote stress related disorders.  For instance, some types of pelvic pain are associated with chronic muscle tension in areas of the pelvis and internal pelvic floor muscles.

Stress Related Issues in the Male Reproductive System

Again, stress causes the body to signal glands to release hormones. During certain stressful times, when certain hormones are released, it can affect testosterone production, sperm production and maturation and can even cause erectile dysfunction.

Stress Related Issues in the Female Reproductive System

High levels of stress can be associated with absent or irregular menstrual cycles.  Menopause can be a stressor in itself with women. For instance, associated anxiety or mood swings during this period can be emotional distress and can cause the physical symptoms to be worse!

Stress and chronic pelvic pain

In a recent article on stress and pelvic pain, it was discussed how chronic pelvic pain is the reason why patients with IBS, interstitial cystitis, vulvodynia, or chronic prostatitis seek medical attention!  Many of these syndromes are not directly associated with an underlying etiology.  With these diagnoses, early in life chronic stress has been shown to increase the likelihood of pelvic pain later in life and acute stress exposure can increase symptom severity.

Here at 5 Point Physical Therapy we promote stress reduction ideas that patients can try: basic meditation and mindfulness, deep breathing, and referral to proper psych consults!  However when reading up on different types of stress reduction, I found some other stress alternatives that I really liked.

  • Being present in the moment, taking 5 minutes a day to scan your body and focus on your senses
  • Reaching out into your social network and talking to others. This can help get a fresh perspective on your stress levels.
  • Taking care of your body.  Working out can be a great stress reducer as long as it doesn’t trigger any current injuries.
  • Decompressing where you take 10 minutes to close your eyes and relax or using a foam roller/tennis ball to massage out any tension in your muscles.
  • Laughing out loud can lighten a heavy mental load and boosts endorphins in your brain.

Everyone is different so find the best ways that relieve your stress.  For me personally it is taking a yoga class where I set a positive intention for myself during the class and to carry out through my day.   I truly believe that managing stress properly can put you in the proper psychological state to benefit from other therapies.