Stress is found to exacerbate neuropathic chronic pain (26) and there is a body of evidence showing chronic pains connection to a chronic activation of the bodies stress system. This is why there is a strong connection to chronic pain activation and the occurrence of an adverse life event, or period of long term stress within the sufferer. I myself can see this occurrence in my life during and prior to my chronic pain and I wonder if you can too. Unhelpfully, pain itself is a signal to the body that activates a stress response, that something is wrong and requires help. In addition, the adverse lifestyle changes and psychological effects of being in pain, such as fear to undertake normal activities for the worry of worsening your pain, can themselves evoke a great deal of stress.
The total combination activates a perpetual cycle of increasing experienced pain and stress, so it in itself can be both the large stressor experienced and the cycle that supports the continuation of the chronic pain. The acute biological responses of the stress can also make us more susceptible to experiencing chronic pain. Adrenalin released as part of the biological response to pain has been found to make people hypersensitive to pain, increasing the pain experienced by the sufferer (37). Over time the brain and nervous system can become hypersensitised and wired to repeatedly experience chronic pain, and studies show this even in the absence of physical structural or tissue damage.
Personally, and scientifically supported, reducing stress and activation of the nervous system, is one of the most important aspects of lowering chronic pain. I would suggest this by taking a three phased approach; incorporating an enjoyable self care activities into your routine and lifestyle; adding in routine methods that are scientifically proven to calm the nervous system; and taking some time to identify what your personal stressors are and considering if you can make some lifestyle adaptions to make these more manageable. The first and third methods will be deeply personal to you, so I would encourage you to do this work.
The second aspect I would encourage you to consider clinically supported avenues such as taking up gentle exercise like yoga, Tai Chi or Pilates that all incorporate deep breathing techniques and are found to enhance physical health and reduce the psychological effects of pain and stress. It is found they can act as a relaxant of the neuro-endocrine system, slowing brain patterns, heart rate and reducing feelings of anxiety and depression, whilst increasing perceived quality of life (24). As previously, exercise in general is found to reduce stress (25), so although the highest results tend to come from those that combine the deep breathing and gentleness, if those avenues don’t seem right for you, general exercise, with the support of your Doctors and therapists, is encouraged.
The psychological and breath work have been found to be beneficial in their own right. Diaphragmatic deep breathing exercises, such as those encouraged in yoga, Tai Chi and Pilates, are found to calm the nervous system and reduce heart rate (40). The breathing can be undertaken in isolation and are a quick and effective method that can be utilised quickly and in the go to calm your system and bring about a sense of calm.
Meditation is well documented to reduce feelings of stress (39) and this 2018 study (38), showed meditation actually changed the brains neurological response to pain, as well as sufferers reporting experiencing less pain.
These methods can be an excellent support for pain spikes and crisis and to help you regulate your pain on a day to day basis. Incorporating these clinically proven stress reducing behaviours into your daily life, has been shown to reduce experienced pain consistently over time, compared to controls not utilising these methods.