Chronic pain takes a relentless toll on both the body and mind of the sufferer. With no reprieve from pain and discomfort, stress becomes an ever-increasing burden. However, there’s a reverse relationship between stress and chronic pain as well, where physical malady follows the presence of chronic stress, rather than preceding it.
Stress, anxiety, and depression each play a role in creating chronic pain that’s perhaps not fully understood or appreciated, but it’s a relationship that is, in my experience, very real, and just as costly on the mind and spirit of the patient.
There’s an intuitive progression to the idea of pain that most people understand. Injury, inflammation, or neuropathies occur and, in the absence of complete healing, create ongoing discomfort or pain. That is, a chronic condition that starts to take a psychological and emotional toll on you, since it interferes with states of rest and relaxation necessary for your body to efficiently heal.
In turn, this stress then provides a negative feedback loop that may interfere with the improvement of your condition. That is, the stress becomes a contributor to the chronic pain itself. This raises an important question: Can stress, on its own, create chronic pain in the absence of any physical reason for the pain?
The effects of stress on the body are well-studied, and it’s accepted that stress can have a profound impact on your physiology. Less clear, though, has always been how individuals respond to stressful situations. What’s a crisis for one person may just be an inconvenience to another.
A common physical reaction to stress is muscle tension, a reflexive guard against pain and injury. When a stressful situation suddenly appears, muscles tense and then release when the situation passes. When this release doesn’t happen, even when the threat passes, stress itself becomes the problem.
As a pain management specialist, the source of chronic pain is essential to me for effective treatment. It’s simple and logical. Relieving the physical source of chronic pain addresses the stress associated with the chronic pain.
However, when stress creates chronic pain in the absence of a physical cause, treatment may be more difficult. Masking chronic pain caused by physical conditions may reduce the amount of stress you experience, aiding the healing process. In the case of arthritis or some other degenerative condition, the pain relief may also relieve the stress, even when the condition continues.
The challenge in the treatment of pain caused by stress is that relieving the pain may have no effect at all on the underlying condition. That’s why I often take a holistic approach toward this type of chronic pain. The stress you experience won’t be relieved with the pain. In fact, it’s possible that medications won’t be effective against stress-based chronic pain.
Alternative therapies are not only quite varied, the effectiveness of any one solution is also varied. For example, one patient may respond well to massage and physiotherapy, while another may see results from transcutaneous electrical nerve stimulation (TENS therapy), and a third patient may respond to acupuncture and meditation.
Just as the response to stress is highly individual, often relief from its effects are highly individual as well.