Do you often feel more pain during times of increased stress?

Pain is regulated by inputs from the brain, spinal cord and the environment and is influenced by multiple factors such as mood, thoughts, activity, sleep and stress [1]. These factors can influence the severity of pain and affect your prognosis. Often when the pressures of family, work and everyday life are weighing on you, not only do you experience an emotional impact but this can also increase your pain intensity and duration. Additionally, experiencing physical pain also makes people feel more stressed, thus creating a vicious cycle that may even lead to chronic injury. Therefore, managing stress is a significant factor to reduce pain and improve quality of life [1,2].

 

Effects of stress on the body

Psychological factors can contribute to increases in muscular tension and postural abnormalities that can accentuate the severity of physical injuries. These changes in muscle and posture can prevent muscles from functioning appropriately resulting in increased pain [1, 3].

For example, in patients following neck injuries, especially if the mechanism of injury was traumatic, they may experience increased muscle tension in the head, neck or upper limbs in addition to adapting abnormal postures that can heighten physical findings in the neck. The body’s response to stress and pain also varies widely among individuals, and these psychological factors could drive pain and take longer to resolve. Due to this variability, it is important to identify factors that may influence a patient’s recovery to potentially prevent re-occurrence [1].

Other effects of stress on your body and behaviour:

  • Fatigue
  • Sleep disturbances
  • Anxiety and/or depression
  • Lack of motivation or focus
  • Changes in mood/irritability
  • Social withdrawal
  • Reduced physical activity

 

What has research shown?

People suffering from psychological distress were shown to be five times more likely to suffer from chronic pain [4]. Current evidence supports the use of pain education for chronic musculoskeletal disorders in reducing pain, improving function, encouraging movement, lowering disability, and minimizing healthcare utilisation [5].

Research also demonstrated the effects of participating in regular exercise as an effective strategy for managing stress. Studies showed that post-exercise there was a significant impact on blood pressure responses to stress that may have implications for cardiovascular health [6,7].

Studies also recommended relaxation techniques such as deep breathing, yoga or meditation. These techniques encourage abdominal breathing which has been shown to promote stress reduction [3].

Overall, multidisciplinary biopsychosocial rehabilitation programs are recommended especially to those who suffer from chronic pain. These programs typically included pain education, pacing physical activities, and psychological treatment to address mood problems, sleep disturbances, unhelpful thoughts and behaviours in addition to medical management [2].

 

Coping strategies

Here are some tips to manage your stress:

  • Practice relaxation techniques such as deep breathing, yoga or meditation
  • Participate in regular exercise (at least twice a week for approximately 150-300 minutes of moderate intensity physical activity)
  • Ensure you have good quality sleep (between 7-9 hours)

 

How can physiotherapy help?

  • Complete a thorough assessment and physical examination of the individual and provide suitable recommendations on ways to improve posture and pain
  • Provide appropriate interventions to reduce muscle tension and pain with manual therapy techniques including massage
  • Create a individually tailored exercise program to increase physical activity and encourage self management
  • Provide education about your condition and help assist you locating appropriate resources to prevent re-occurrence

If you have any questions regarding whether we can help you manage your stress and pain better, please give us a call at (02) 8411 2050. At Thornleigh Performance Physiotherapy, we can give you an accurate diagnosis and treatment, to help you get back in action as soon as possible. We are conveniently located near Beecroft, Cherrybrook, Hornsby, Normanhurst, Pennant Hills, Waitara, Wahroonga, Westleigh, West Pennant Hills, and West Pymble.

 

References

  1. Brukner, P. (2012). Brukner & Khan's clinical sports medicine. North Ryde: McGraw-Hill.41-52, 332-333.
  2. Kamper, S. J., Apeldoorn, A. T., Chiarotto, A., Smeets, R. J. E. M., Ostelo, R. W. J. G., Guzman, J., & van Tulder, M. W. (2015). Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis. Bmj, 350, h444.
  3. Berger, B. G., & Owen, D. R. (1988). Stress reduction and mood enhancement in four exercise modes: Swimming, body conditioning, hatha yoga, and fencing. Research quarterly for exercise and sport, 59(2), 148-159.
  4. ABo, S. (2007). National survey of mental health and wellbeing 2007 (Cat. no. 4326.0). Canberra2007.
  5. Louw, A., Zimney, K., Puentedura, E. J., & Diener, I. (2016). The efficacy of pain neuroscience education on musculoskeletal pain: A systematic review of the literature. Physiotherapy theory and practice, 32(5), 332-355.
  6. Hamer, M., Taylor, A., & Steptoe, A. (2006). The effect of acute aerobic exercise on stress related blood pressure responses: a systematic review and meta-analysis. Biological psychology, 71(2), 183-190.
  7. Hobson, M. L., & Rejeski, W. J. (1993). Does the dose of acute exercise mediate psychophysiological responses to mental stress?. Journal of Sport and Exercise Psychology, 15(1), 77-87

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