Stress and Pain Management

Stress and it’s effect on our Body and Pain

Had a stressful week?  You’re not alone. 

Stress affects most of us. According to the Canadian Mental Health Association, in a recent Canadian poll, about one-quarter of Canadians said that they feel “quite a bit stressed” or “extremely stressed” most days. In the past year, 74% of people in the UK have felt so stressed they have been overwhelmed or unable to cope.

With all of the chaos on our world these days, who is surprised!?

Anyways, we can handle it right? Don’t we just push through and hope for the best?

But wait, How does stress affect our body?  

Stress is a complex physiological process in the body that has multiple responses in our system.

Stress symptoms can affect:

  1. your body,
  2. your thoughts and feelings, and
  3. your behavior. 

Knowing common stress symptoms can help you manage them. Stress that’s not dealt with can lead to many health problems, such as high blood pressure, heart disease, stroke, obesity and diabetes.

How can stress affect my body? How does body pain affect my stress?

Stress can make you more likely to sustain an injury or to experience pain when you do have a hard activity or overload.

Stress responses in the body elicit a response in the autonomic nervous system (ANS).  The ANS can be split into two parts, the Sympathetic Nervous System (SNS) and the Parasympathetic Nervous system (PNS).  The SNS is our “FIGHT OR FLIGHT” response, and the PNS is classically knows as the “REST AND DIGEST” response in the body.

When we feel stressed, our body naturally goes into the “FIGHT OR FLIGHT” mode but we often push through to try and keep going and doing what we need to do at home, work and sport.  When in this SNS heightened mode, many of the muscles in our body become tense trying to prepare to effectively be chased by a lion!  However, there is no lion and during our day or when our day ends, if stress is not managed, our body stays in this heightened SNS state. This means that often our muscles sit in a chronically tense or overactive state, which can lead to muscle pain and muscle tighness, as well as lead to overall compression of our joints and possibly arthritic changes in our joints.

In times past, if we were chased by a lion then the SNS would jump in to kick us into action to help run away from the Lion, but once the Lion was gone, our system could relax back to a more PNS state.  However, in this day and age, it seems with our day to day life, there is always a stressor, whether it be work schedule, demands from home with children, household chores, daily needs or extra tasks such doing your tax returns. Sometimes it just never ends! Right???

In the end, we don’t tend to reset to the calmer PNS state of things when we are under chronic stress.

We can continue to do this chronic stress thing for a long while, and many of us are quite resilient!   However, there becomes a breaking point where our body can’t sustain the loads that are being put on it.  If we are not getting enough sleep due to chronic stress, as well as changes in cortisol stress hormone levels and heightened SNS, we can become more likely to sustain an overuse injury or pain and generally feel quite miserable. Sleep is when we restore and rejuvenate but when we are under chronic stress, sleep patterns can also affected.

What happens when we breathe shallowly?

One of the other physiological responses that we experience when under stress is that we tend to breathe more shallowly.  This means that we are not getting deeper breaths, and we tend to breathe only in the upper part of our lungs.

When we breathe shallowly, the following responses occur:

  1. Mechanical tightness in the neck and upper back when our accessory breathing muscles become primary breathing muscles and stay tight all the time to help us breathe – this can lead to neck and back pain due to poor distribution of pressure in the system and tension in diaphragm which also affects the ability to use our core muscles properly.
  2. Reduced oxygenation of our tissues  – this can lead to increase in CO2 of our muscles and more muscle related pain and soreness.  Also, our muscles cannot perform as well with less oxygen.
  3. Elevated resting muscle tension throughout the body.  However, relaxation can occur with deep breathing exercises focused on restoring the mobility and function of the diaphragm, and with this the PNS is typically stimulated, leading to a general relaxation effect in the body and often softening of our resting muscle tightness.

When pain leads to stress on the system

Similarly, when we have a painful injury or surgery, our body goes into a protective mode to help avoid the pain if possible.  This often leads to elevated SNS and stress response, as well as shallow breathing.  It can be a catch 22 whereby a painful injury injury leads to increase stress, where the increased stress also perpetuates the pain and leads to muscles tightness and shallow breathing, which may perpetuate painful tissues and muscles.

Common physical symptoms of stress are:

  1. Headaches
  2. Muscle tension or pain
  3. Fatigue
  4. Chest pain
  5. Stomach upset/nausea
  6. Sleeping problems
  7. Poor physical performance at work or sport

How does stress affect my thoughts and feelings?

Stress can make us feel depressed or anxious, especially if we are having ongoing chronic stress or a chronic painful issue that is limiting your activity or ability to enjoy your daily life.  

Common thoughts and feelings associated with stress:

  1. Anxiety
  2. Lack of motivation
  3. Depression
  4. Sense of worthlessness
  5. Sadness
  6. Anger/frustration
  7. Lack of ability to focus/concentrate

When we are living in pain, we also can have chronic stress and feelings related to worthlessness or poor self image when we are not able to do the activities we love to do.

How does stress affect my Behaviour?

When under stress, we often demonstrate unhealthy behaviour such as:

  1. Overeating/undereating
  2. Angry outbursts
  3. Lack of patience
  4. Isolation – avoiding friends/family
  5. Avoiding exercise, sometimes over-exercising if this is a strategy you use to manage stress (this is sometimes how people get injured also by exercising too much or too intensely trying to manage their stress)
  6. Overuse of medication of alcohol to try and mask the symptoms and feel better.

WHAT CAN I DO TO MANAGE STRESS?

If you’re feeling generally stressed, managing it can improve your health in many ways. Here are some simple tips to help:

• Exercise regularly, aiming for most days of the week.

• Practice relaxation techniques like deep breathing, meditation, yoga, tai chi, or get a massage or physiotherapy treatment.

• Keep a good sense of humor and try to laugh as much as possible.

• Spend time with loved ones and really “be” with them (maybe put your devices away?).

• Make time for hobbies—whether it’s reading, listening to music, or taking a walk. Prioritize what you enjoy and try to embody the good feelings.

• Try journaling to express your thoughts or worries.

• Ensure you’re getting enough sleep – aim for 7-8 hours per night.

• Eat a balanced and healthy diet.

• Avoid tobacco, alcohol, and illegal substances.

I have pain and stress  – HOW can Physiotherapy Help?

Sometimes these basic stress management strategies are not enough, but can still be generally helpful.  

However, if you are dealing with an injury or pain that is causing you stress or stress that has possibly made you vulnerable to pain and injury, please make an appointment with one of our physiotherapists.  Our talented team of physiotherapists have years of experience working with a range of injuries and needs.  

Our physiotherapist will review your injury, provide a full assessment of the root cause of the pain and help you get on track with what to do.  Having a plan in place often helps to take away some of the worry or guesswork when you’re having pain.  It helps to give you a firm idea of what is going on and how it can best be managed.  This is SO EMPOWERING! And it helps you feel like you have some control over the pain or understanding of it at least and what is happening to your body. Otherwise, it can be quite a scary experience for people in pain.

Dealing with a painful injury that increases your stress levels can bring you to the breaking point where it warrants attention to help resolve.  We are here to HELP!

Our physiotherapists are well versed in dealing with the mechanical side of your painful injury, but also the personal and emotional side of your painful injury.  We will work to help release tightness, get you moving better using techniques like manual therapy and IMS , provide exercises for home management and education as to how to protect your injury, such as how to sit better at work, how to do a good dynamic warm up etc.  Overall, our physiotherapists will work to give you ideas and suggestions for managing the physical condition as well as the stress and worry relating to your injury.  If there is an ongoing emotional component to your painful injury that is slower to resolve, we may suggest working with a team and involving a counsellor or other health professional to help you work through the emotional aspects while we can continue working on the physical aspects of your painful injury at Physiotherapy and at home.

We look forward to helping you be your best self!  Please reach out.  We look forward to seeing you soon and helping you mitigate your stressful circumstances or injury.