Does Stress Make Chronic Pain Worse?

In these uncertain times, it’s natural that many of us are feeling more stress and anxiety. Even if you and your family are healthy and safe at home, fear of the unknown and the troubles of others can weigh heavily on all our hearts and minds.

If you or someone you love experiences chronic pain, you may wonder whether all this stress can make that pain worse. Or maybe you’re already experiencing more severe pain and wondering whether stress is to blame.

The Cycle of Stress and Pain

Let’s first acknowledge the obvious. Chronic pain can be a source of stress. It may make it harder for you to work or care for your family. It may interfere with your rest and sleep. And hurting all the time is inherently stressful. Your body is always looking for a way to relieve or escape the pain.

So pain can absolutely cause stress. But can stress also make the pain worse?

While the answer is less clear, there is a growing consensus among researchers and pain management specialists that it can. This is not to suggest that the pain isn’t “real.” It’s very real. But stress may be making it worse.

According to an article published by the Institute for Chronic Pain (reporting on a manuscript in the Journal of Pain), stress can activate the immune system and cause increased inflammation. And inflammation can aggravate many causes of chronic pain.

A 2015 meta-study published in the Malaysian Journal of Medical Sciences found that stress can cause both analgesia and hyperalgesia: reduced or increased sensations of pain. While the results were complex, increased pain seemed more common in cases of chronic stress than with occasional, isolated stress. Negative emotions also heightened the impact of stress on pain. (A stressful but enjoyable experience, such as competing in a sport, may be less likely to increase pain.)

And in a 2017 manuscript published by the Department of Health and Human Services, the authors suggest that chronic pain and chronic stress are two parts of the same underlying neurobiological system, interrelated in subtle and intricate ways.

Research in this area continues, and we don’t yet fully understand how pain and stress are related. However, if you’re experiencing chronic stress, it may very well be making your chronic pain worse.

What Can You Do to Ease Anxiety?

If stress is making your chronic pain worse, there’s a lot you can try to ease that stress and possibly ease your pain too. Your United Physician Group family medicine doctor or pain management specialist can help guide you to effective stress relief and pain management.

Your options may include:

Lifestyle Changes

• Regular exercise: If your chronic pain doesn’t prevent it and your doctor approves, exercise can help you manage stress.
• Quality sleep: Chronic pain and stress can make it harder to sleep, but, if you can develop good sleep habits, the rest may ease your stress.
• Good nutrition: A healthy diet keeps your body in balance and better able to handle each day’s challenges. Also consider moderating or eliminating caffeine and alcohol, which can make stress worse.
• Complementary treatment: Yoga, massage, meditation, guided breathing, and other supportive treatments may help ease your stress.

Therapy

Cognitive Behavioral Therapy (CBT) can help you develop skills to better manage stress.

Medicine

Some prescription medications, such as selective serotonin reuptake inhibitors (SSRI) and antidepressants, may treat chronic pain and chronic stress simultaneously.

You Don’t Have to Figure This Out Alone

If you’re hurting and under stress, the most important thing you can do is to reach out for help. You don’t have to have all the answers. Reach out to your pain management specialist, and let us know what you’re going through. We’ll help you figure it out.