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  • Writer's pictureGiulia Pline

The link between stress & pain


Image courtesy: Greensboro Chiropractic


“Stress can contribute to nerve sensitivity or pain system sensitivity. Stress lives in the brain, and therefore the experience of people with chronic pain often is that their pain increases as they become more stressed."

- Dr. Lorimer Moseley


Is your injury or pain not getting better? Performance at work or in your workouts/other movement practices decreasing?


One potential culprit may be stress.


Before we dive in, let's clarify that not all stress is has negative consequences (we will revisit this a few short paragraphs from now).


Persistent pain can show up in many different areas of the body from the neck, to the lower back, knees, shoulder, hips... it can even show up in the form of frequent or recurring colds, headaches/migraines, or as abdominal pain.


Over the past year, I have been completing prerequisites to apply for a graduate Doctorate of Physical Therapy program this fall. As of late, I have been in summer school and have been furiously studying, homework-ing, and quite frankly stressing my way through everything, trying to complete a hefty amount of work in a short period of time...


A few weekends ago, my partner and I were able to escape up to the mountains and spent close to 2 weeks hiking and immersing ourselves in the calm and beauty of nature. I slept so soundly and felt like I finally was able to relax and unwind.


But then... (cue spine-chilling music)...


...We got in the car and started driving back to NYC. As the beautiful, green landscape progressively flew quicker and quicker past us into the rearview mirror, I could feel my neck and jaw tightening. Not too long after, we started to hit some traffic and my breathing became short and quick. Then before I knew it, the exit to home was in 5 miles and I suddenly had stomach pain. Ha!!!


Have you ever had this experience? Maybe you are dealing with an ache or pain and then you go on vacation, and during your vacation you start to feel better. Your pain diminishes or even disappears, only to come roaring back on Monday morning before the 9am work meeting, phone call, or client/class...


Pain is an output, not an input. This means, pain is just one part of many other protective mechanisms that the brain puts out in response to threat. 


There are two types of stress: eustress and distress.


Eustress is the type of stress that can be beneficial and motivating, even performance enhancing. For example, when I had to take my Physics final over the summer, I experienced eustress in the form of butterflies in my stomach, nervousness, and pressure to perform well. This stress motivated and energized me to focus and pass the exam. After I completed the exam, I was able to let it go of it and return to baseline.


On the other side of the coin is distress, the kind of stress that can cause health issues. This type of stress is the chronic kind that can make you feel burned out, fatigued, exhausted, and like your performance starts to decline. It can come from many things, including and not limited to: doing too much high intensity exercise, having unmanageable pressures at work, experiencing a breakup or divorce, having to care for a sick family member or loved one, losing a loved one or pet, suffering an accident or assault, having chronic or persistent pain... the list goes on.


Remaining in a state of distress can be detrimental.


Hans Selye was the first scientist to identify stress as an underlying cause of dis-EASE and symptoms of illness in the body. Selye discovered what is known as general adaptation syndrome, or the body's non-specific physiological response to stress. 


This syndrome has 3 stages:


Alarm Reaction: The body's immediate reaction upon facing a threat or emergency. The fight-or-flight stage. Here, the body's non vital processes like digestion shut down as heart rate increases, muscles tense, pupils dilate, and breathing rate quickens, all preparing the body to either fight or flee from the perceived threat.


Stage of Resistance: The initial shock of the alarm reaction has worn off, but the body has not adapted to the stressor. Here the body is still on alert and prepared to respond, but with less intensity. 


Stage of Exhaustion: This is also known as chronic stress, or being in survival mode. If exposure to the stressor continues over a longer period of time, this stage ensues. Here the body is no longer able to adapt the stressor and function/health begins to decline from the stress. Disease, illness, chronic pain, or other health problems can develop.


So what can we glean from Seyle's theory? Stress can lead to persistent pain, and pain is multifactorial.


If you are experiencing persistent pain, check in and see if part of your pain is coming from being stuck in survival mode and check out the additional posts/links below for strategies to help you recover from distress.


Check out the Instagram post below

which highlights 5 signs that your persistent pain or decrease in performance may be as a result of your nervous system being in survival mode (aka stage of exhaustion or state of distress):



Try this simple and effective breathing practice

to help ease stress, soothe anxiety, and promote relaxation:



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