Stress and pain are parts of a relentless cycle, say experts, with both fueling each other, compounding both physical and mental agony. For instance, people who endure chronic pain often stress over it, which in turn can aggravate or trigger the pain. This self-feeding cycle holds true for almost all forms of pain, ranging from headaches, stomach pains and aches in the joints.
The issue is magnified by the basic human tendency to withdraw oneself when in pain. This exacerbates the feeling of being low, leading to anxiety and depression. Continuous pain can even affect one’s work life and quality of life in general.
To ensure one doesn’t spiral into this pain-stress cycle, it is important to understand the telltale signs of pain-induced stress and keep it at bay. At the same time, efforts should be made to diagnose the root cause of the pain itself and heal or eradicate it.
How does stress aggravate pain?
Multiple mechanisms can aggravate pain when we are stressed. “When stressed for a long time, an individual may experience muscle spasms,” says Dr Sasmit Lotliker, interventional pain specialist, Manipal Hospitals, Goa. “As a result, they will have increased pain, also referred to as myopathic pain.”
Stress also increases cortisol (stress hormone) levels, which causes the release of proinflammatory cytokines, leading to inflammation. “When the stress becomes too much for our body to take, the levels of cortisol and other stress hormones increase,” says Dr R Vasanth, psychiatrist, Fortis Malar Hospital, Chennai. “When the hormone levels increase, we perceive more pain. That’s why headaches resulting from tension or any other body pain tend to increase whenever we are stressed.”
How does the body react to stress?
The autonomic nervous system is divided into sympathetic and parasympathetic nervous systems. “The sympathetic nervous system mainly stimulates the fight-or-flight response in reaction to acute stress. The parasympathetic nervous system, on the other hand, keeps you relaxed and calm after a period of danger or stress,” says Dr Lotliker.
These two systems work in conjunction throughout the day. However, when a person is under stress, the sympathetic system starts dominating. “In an acute state of stress, the body will release cortisol, which will help in relieving the stress by repairing the tissues and nerve damage through its anti-inflammatory properties,” adds Dr Lotliker.
However, if the stress persists for a long period (chronic stress), the cortisol levels will increase to a point where the proinflammatory cytokines continue to be released. This aggravates tissue and nerve damage.
Stress can cause muscle spasms
Dr Lotliker explains that with an increase in stress, the nutrient supply to the muscles decreases.
“Because of stress, people tend to remain inactive; they may not exercise and live sedentary lifestyles,” adds Dr Lotliker. “This lifestyle, where the muscles will not be in much use, will lead to muscle spasms. It starves the muscles of nutrition, leading to dehydration. All these factors will contribute to pain.”
How to balance stress and pain
Experts prescribe a holistic approach for managing stress and chronic pain. The first step is to ascertain whether the stress is causing the pain or if it’s the other way around. Popping painkillers is not the way to go. “When it comes to stress management, breathing techniques (pranayama) and different types of meditation are recommended,” says Dr Lotliker. “Doing aerobic exercises like running, jogging, swimming and cycling will also help reduce stress.”
Physical activities, deep breathing and meditation will reduce oxidative stress in the body, eradicating the free radicals that cause tissue damage. In addition, stress has no cutoff value; each person has a different threshold. One has to understand the stress factor that is causing pain as well as their threshold. “Once you control your reaction to the stressor after identifying it, the stress will automatically reduce. You will start feeling better and will be able to handle stress more effectively,” says Dr Vasanth.
If access to medical experts is a problem, seeking help from support groups or support systems is also an option. When it comes to chronic pain, its two components – nociceptive and neuropathic pain – should be addressed. When we take painkillers, we mostly address only the nociceptive pain (sharp pain resulting from damage to the body tissues). To address neuropathic pain (pain resulting from nerve damage), one must consult a pain specialist, avoiding self-diagnosis or treatment through internet research, cautions Dr Lotliker.
- Stress and pain can work hand in hand. Chronic pain can induce stress, which in turn can exacerbate the pain.
- Understanding the cause of stress and controlling the reaction to it will help you handle stress and address the pain more effectively.
- Breathing techniques, meditation and physical activities (aerobic exertions) will help manage and reduce stress, which in turn can play a part in alleviating pain.