Pain 6. The effect stress has on pain and healing rate.

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Mental attitude has a big effect on pain levels.

The relationship between pain, stress levels and rate of healing is complex.  How we live our lives can help or hinder pain and recovery, but all too often we get trapped into a rut of rush, rush, rush, paying scant attention to the needs of our body.   Chronic pain debilitates us.  To overcome this, the best thing for us to pay attention to is getting enough sleep and relaxation time.  To understand why, here are 3 different ways that pain and stress interact.

The first way stress interacts with pain actually reduces pain levels.  In the shock of a horrible happening our brain sets us into defence mode, with all systems geared to getting us out of there.  Should we trip and twist or break an ankle, our wondrous brain sends out strong pain killers and keeps inflammation at bay so we can keep on running until we reach safety.  If we really hurt our back, the brain enters us into survival mode, reducing pain, reducing the desire to eat and rest until we ‘reach safety’.  This all happens because of the production of the stress hormones, adrenalin and cortisol.

Now we are not actually invincible nor are we machines.  Unfortunately our lives these days mean, unless we are very careful, we can lurch from mini-stress event to mini-stress event throughout the day.  We get very sweaty about the small stuff;  does it really matter if someone barges in just in front of us?  Does it really matter that they’ve run out of tomatoes in the supermarket?  So due to the eternal pressure on us to get there, to do that, to be ready and do two people’s jobs, mean we get over stressed and lose perspective of what really matters. The price we pay for this constant escape from troubles means that all systems in the body devoted to repairing us, to digesting our food, to making babies, are put on stand by.  For any injury, short or long term, to heal,  the body has to truly enter the relaxed healing mode.   But when we are stressed, where pain is concerned, this has the interesting effect that during the day, when stress hormones are high, pain levels are kept down by the body’s painkillers – endorphins.  But in the evening, when we finally do creak to a halt, pain levels rise as endorphins sink.  If this is familiar, then we will be wise to pay heed to the body chatting away to us and do something about it.  Because otherwise things can only get worse because our cells will become resistant to the anti-inflammatory effects of the stress hormone, cortisol, as we will see.

The second interaction is having long term pain along with long term stress- which leads to a vicious circle of slow recovery rates and bad sleep.  So we have back ache.  We never quite know when it is going to go off and leave us a groaning heap.  We feel that slight constant worry.  This raises stress levels – but we don’t let the back ache stop us busying about in our life.  Rush, rush, rush.  At night, we feel quite pooped out, and after a slump on the sofa, sink thankfully into bed for a night’s restful sleep.  Only, of course, we don’t sleep well.  How can we?  Our back hurts, we are still stressed about the day and bothered about tomorrow with its usual list of a million things to do. And a slow recovery from a painful event itself makes us sleep badly.  Regular poor quality sleep leads not only to slow recovery rates, but also to depression, poor memory, and general feebleness.  We enter a vicious cycle.   So for the body to enter repair mode, it has to have stopped generating stress hormones and generate the hormones of relaxation.  Even Bob Marley, who I can’t normally abide, sounds wonderful – peace, love, joy to weed, and jah.  And we sleep with the angels tootling overhead.

Finally we have the interaction of pain and the immune system.  With on-going pain, the immune system gets ramped up and produces inflammation to try to protect the joint -and protect the body.  This can be a learnt response. We have a sore knee; see a flight of stairs ahead that we have to rush up and then down the other side to catch that train, and our brain is already anticipating knee pain a result, and the body ramps up its inflammatory response in preparation.  Furthermore, as reported in Nature Magazine, June 2012,

stress induces cellular resistance to cortisol, reducing the body’s ability to regulate inflammation, which is at the root of many diseases, including heart disease.

This scary statement means that with continued stress, the cells become resistant to the stress hormone, cortisol’s anti-inflammatory effects, as mentioned in the second paragraph above. Therefore long term pain is much more than just a nuisance.  It is very debilitating to health; uncontrolled inflammation is now thought to be a root cause of many modern diseases such as heart disease and diabetes.  Long term pain destroys good sleep and life’s joy.

What to do?  To speed recovery rates is to reduce stress levels, and to achieve both we need supportive friends and family; possibly a pain support group plus helping professionals; a strong belief helps – whether a religious belief or a belief that this will end; exercise that leaves us feeling good; being in control of our lives; sorting out the sleep – and laughing.  Then we can stop getting in a fizz about bugger all, we can let go and allow the body to enter that magical state of relaxation and let the poor thing get on with its repair jobs.

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