Chronic pain. It can be all-encompassing. Governing your every minute from when you wake up to when you go to bed and, even then, destroying any hope of real sleep.
When you are living with chronic pain you might feel like the pain puts everything in a different perspective. You can’t just go for a simple walk, get a good night’s rest, or play with your children or grandchildren. The pain is in charge. It tells you what to do each day.
This type of pain that consumes your life can take a heavy toll on your emotions, leaving you anxious, stressed, and depressed.
Definition Of Chronic Pain
Chronic pain has been defined as “persistent or recurrent pain lasting longer than 3 months”. Chronic pain is pain that persists long past the normal amount of time that it generally takes for an injury or illness to heal.
In most cases, pain helps our bodies respond appropriately to an injury or illness, notifying us of the issue, and letting us know what activities to avoid to prevent further damage occurring.
If pain becomes chronic, lasting months or years instead of days and weeks, then the pain that was trying to send us a message is no longer useful to our bodies.
Unfortunately, chronic pain is more common than we think, affecting around 20% of the world’s population and accounting for around 15% to 20% of doctor visits.
Types Of Chronic Pain
Chronic pain has been generally divided into 7 different groups:
Chronic primary pain
Chronic musculo-skeletal pain
Chronic headache or orofacial pain
Chronic cancer pain
Chronic neuropathic pain
Chronic posttraumatic and postsurgical pain
Chronic visceral pain
What Is Chronic Stress?
Chronic stress is very similar to chronic pain in many ways. Stress can be useful for our bodies in small doses. It can help us cope with life-threatening situations, like running away from danger.
When we are stressed our bodies release special hormones that increase our levels of adrenaline and cause our heart and breathing rates to go up.
Fight Or Flight
Stress is responsible for that "fight or flight" response you may have heard of, helping to fire up our muscles so that we can run away from potentially serious situations. Chronic stress is like chronic pain, it lasts long after the useful period is over.
Ultimately, stress is the sum of the physical, physiological, and psychological reactions that our bodies have when we are in perilous predicaments, and it doesn’t matter whether those predicaments are genuinely dangerous, or if they are just perceived by our subconscious to be dangerous. Either way, our bodies know when to tell us to get the "heck out of dodge" or "play possum".
Impact Of Chronic Stress
Chronic stress, unfortunately, is not so helpful to our bodies. Chronic stress is generally defined as a "consistent sense of feeling pressured or overwhelmed for a long period of time". Our bodies were designed to respond to stressful situations and either run away or find a way to fix them.
Unfortunately life has evolved faster than our biology in that department, forcing us to deal with situations that our ancestors did not have to face. Their biggest challenge was running away from a bear or fighting off a lion to defend the family.
Modern day stress is constant. Relentless. Always rushing. Always having to meet work deadlines. Always having to sit in traffic worried you are going to be late for work or for school. Never actually getting to run away from things and relax.
Symptoms Of Chronic Stress
Just like chronic pain, our bodies are only designed to handle stress in small doses - not to be exposed to it every day for months and years on end. When we are living in a constant state of stress we can start to experience some of the following:
Emotional symptoms Of Stress
Feeling overwhelmed
Feeling moody
Feeling agitated
Low self-esteem
Depression
Anxiety
Difficulty relaxing
Avoiding others
Physical Symptoms Of Stress
Upset/sore stomach
Headaches
Nausea
Sore, stiff muscles
General bodily aches and pains
Back pain
Insomnia
Frequent colds and illnesses
Low energy
Loss of sexual desire/ability
Clenched jaw
Teeth grinding
Cognitive Symptoms Of Stress
Racing thoughts
Constant worrying
Inability to focus
Poor judgement
Indecisiveness
Pessimism
Forgetfulness
Why Does My Back Hurt When I Am Stressed?
As you can see, chronic pain and chronic stress are both useful functions, initially, but they turn into more serious issues when they don’t resolve themselves in the appropriate time frame.
People with chronic pain are more likely to experience a stress response to their pain as “fight or flight”. The stress seems to produce a physical response most of the time, leading to tense muscles or muscle spasms which can then lead to further injuries. The biological effects of stress can also wreak havoc on their immune systems, making them more susceptible to other injuries and illnesses.
The Role Of Cortisol In Stress
Like the rest of us, chronic pain sufferers also feel the effects of stress on their hormones. Stress causes our bodies to increase the production of a hormone called cortisol which has several negative effects on how our bodies experience pain and it can be one of the key answers to the question "why does my back hurt when I am stressed?".
Cortisol increases our heart rate, elevates our adrenaline levels and intensifies our perception of pain. This all goes together to create a physical response to pain that is enhanced when we are stressed.
It comes as no surprise then that when we are going through a stressful experience, we might also experience an increase in low back pain. Pain can increase our stress, which can then increase our pain - creating a vicious pain cycle.
Recent Research On The Link Between Stress And Pain
A recent study, published in the journal 'Frontiers In Medicine' in May of 2022 looked at 120 people who were experiencing various types of stress. Stresses ranged from "excessive demands at work", to "social overload".
Based on their levels of stress, the researchers wanted to predict who would end up with low back pain. Outcomes included:
- chronic pain
- fatigue
- depressive mood
The researchers found that 'Excessive demands at work, Social tensions, and Perceived stress' were significantly associated with the intensity of chronic low back pain, while 'Social tensions and perceived stress' as well as 'critical life events' were associated with CLBP disability.
What Can You Do About It?
Many of the steps you can take to control stress will also reduce your pain. Here are some lifestyle changes that can improve both:
Stay active.
If your pain doesn't prevent you from moving too much, regular exercise can be a huge help to managing chronic pain and stress. When we engage in regular physical activity our bodies create endorphins that can help boost our mood. Exercise improves circulation and reduces stiffness. If your doctor gives you the all clear to exercise try some fun low impact activities such as walking, swimming, or bike riding.
1. Sleep well
Sleep is a highly under-rated tool for managing chronic pain and stress. Getting quality sleep is key for maintaining physical and emotional well-being.
Practicing good sleep hygiene, having a set routine and regular sleep and wake times can play a pivotal part in managing chronic pain.
We know that it can be a bit of a chicken and the egg situation where chronic pain can stop you from getting good sleep, but if you can persist with your routine many chronic pain sufferers find that they do get into a sleep routine eventually.
2. Eat Nutritious Foods
A balanced diet that consists of anti-inflammatory foods and fewer processed foods can help keep your body in balance and can actually help you handle some of the day's stresses.
Avoiding caffeine and alcohol can help your body as they can interfere with your sleep cycle and can make your stress levels worse. Alcohol often helps us fall asleep but due to the sugars in the alcohol we end up waking up later in the night and not being able to fall asleep again for a while.
3. Mindfulness/Meditation
Meditative practices like yoga, deep breathings, massages, and mindfulness can help your body and mind relax and have been scientifically proven to reduce our perceptions of pain.
4. Have Fun
When you are experiencing a pain flare up. or your chronic pain feels like it is consuming you, find some distractions to take your mind off it.
Taking a walk in nature, watching a great movie or hanging out with a friend are all wonderful ways to disengage from the pain for a while and can take your mind off things for a bit.
5. Therapy
Cognitive Behavioral Therapy (CBT) is a type of therapy that helps train your body and your mind to better manage stress. It helps to reframe your thoughts around stressful or painful situations and to see things in a different perspective.
CBT is recommended by international guidelines to help manage low back pain as it can help reduce stress and tense muscles.
Conclusions
It is estimated that around 50 million adults in the US suffer from chronic pain and 33 percent of people report experiencing chronic stress. Our bodies are only designed to cope with so much before they try and tell us that we need to slow down and take better care of ourselves.
The mind-body connection does just this. Our bodies operate as a whole and when we take care of one part, it can have positive effects for other parts of our bodies.
We know, managing stress is HARD! But the more time and effort that you can put into managing your stress levels, the better results you will see in your experiences of chronic pain.
Let us know what some of your favorite ways to manage chronic pain/chronic stress are - we love hearing new ideas!