Stress contributes to pain, but it’s also necessary for normal function because it provides us with motivation.If we have too little stress in our lives we don’t feel motivated to take action, try to achieve goals and get results in our lives that grow our confidence. But if we have too much stress, we’re in a constant state of tension. This can impact on our mental health, and it can also heighten our experience of pain and decrease our ability to function well.
Stress goes through our communication system via the nervous and the hormonal systems, which command our body to take action. Our brain tells our muscles to move when we think about taking an action or resisting an outside force.
Other systems in our body are activated by the autonomic nervous system. It’s called the autonomic nervous system because it’s part of the nervous system that has autonomy (independence) from conscious thought. In normal situations – when we’re not too stressed – our parasympathetic nervous system (a part of the autonomic nervous system) is in action so we can digest our food, we can breathe at our usual rate, and our heart will pump and beat at its normal rate and rhythm.
However, when we perceive a threat to our safety. Situations in whichwherethe body needs to protect itself, the sympathetic nervous system (the other part of the autonomic nervous system)it turns on what’s called our ‘fight or flight’ response. This creates physical signs of stress.
During the fight or flight response, the skeletal (voluntary) muscles tense up, ready for action. This enables the body to respond quickly to act appropriately when in danger –either to defend and protect against the danger (‘fight’) or to run away from danger (‘flight’).
It’s a survival mechanism. So when our control centre sends out a message via the fight or flight response, the messagespreads fast. The nervous system will get our heart and lungs ready for action quickly so that our body will have oxygen when it needs it the most. The heart starts beating fast, or you might find you’re taking deeper, quicker breaths so that your blood is oxygenated rapidly. This enables muscles to be quickly replenished with a good oxygenated blood supply to produce more energy when needing to kick into action.
If you’re in a lot of pain, all this can go wrong. Your nervous system gets wound up because you’ve got too much tension and stress in your body. Your body is constantly set on alert. If this situation is prolonged, the body becomes exhausted and fatigued.
If you’re constantly anxious or you have intense pain for a prolonged time, your body might change its set point for pain sensation. It sets the ‘thermostat’ for pain at a lower level, so that you’re ready to ‘take action’ with a relatively small trigger or stimulus, even when there isn’t normally a need to do this. So sensations that would normally feel be within the bounds of bearable, such as heavy pressure, may be experienced as painful.
Also, your central nervous system (brain and spinal cord) may also change its set point, registering things that would normally be a pain-free experience (but perhaps a strong sensation) as being painful. For example, making your hand a fist is a normal position. But if you keep your hand in a fist long enough, having an open hand then registers as painful (even though the open hand is actually the more normal position – you can’t grasp objects with a closed hand).
Tension and stress isn’t good if it occurs over a long period of time. hormones such as adrenaline build up in the body, putting the system on constant alert. This state is very exhausting. That Itcan actually make you more tired and even more anxious.
As physiotherapists, we can teach your body how to adopt a different set point for the perception of pain.
By enabling the mind to experience what it’s like to slow down, we can change the anxiety set point so that a constant state of stress. Sympathetic hormones such as adrenaline and cortisol are less likely to be produced so the nervous system isn’t kept on alert. Muscles can then relax, so muscle pain and problems from poor posture are reduced.
We might also help you to develop some relaxation with hands-on techniques, as because touch itself can be very calming.
Body work that we use when using a hands-on approach can stretch out tissues so you feel more relaxed.
Where stretching causes pain or discomfort, we can also use specific techniques that may draw on existing bodily reflexes and responses, or different movement patterns, to retrain your systems so that a particular posture or movement is less likely to be perceived as painful. With practice and time, your body will adapt to being pain-free more regularly.
Certain types of stress conditions may need the help and support of a psychologist, or medications from a psychiatrist to help change the nervous system and pain response.
There are other particular conditions in which physiotherapy can’t help the pain and these are usually situations involving areas outside the musculoskeletal system. In these cases we would refer you to an appropriate health practitioner.