THE STRESS AND PAIN CONNECTION

‘Neuro’ means nervous system and ‘endocrine’ refers to hormones. Together, it’s the system that modulates several major glands that release hormones directly into the bloodstream to influence all of our physiology.

The neuroendocrine system… it’s kind of a big deal, which is why it’s such a huge surprise that this system is so often overlooked in pain. The protective immune system doesn’t get the attention it deserves either.

It’s time to set the record straight and talk about the science behind persistent pain.

In Parts 1 and 2 of this blog series, you’ll learn about the influence that persistent pain and stress have on the major endocrine glands so that you can appreciate all the fascinating ways your body tries to protect you.

In Part 3, you’ll gain strategies, including eight yoga postures, for calming persistent pain. Knowing more about how your body functions will help you apply these tools to your unique body and mind. Result? Feeling physically safe and comfortable, and regaining mental freedom.

Note: I’m going to way oversimplify some of the science for the sake of your sanity, but know that these bodily systems are much more complicated than we can cover in a brief blog series. Here goes!

Pain Equals Stress

Pain, despite being a normal universal human experience, is a major stressor and a great motivator for life changes. However, not all changes create long-term quality of life. In cases of persistent pain, it can be quite debilitating and an emotional rollercoaster ride.

Pain-related fears or unhelpful thinking patterns and beliefs around pain can add fuel to the fire when it comes to calming sh*t (AKA your nervous system) down. In order for you to apply strategies to put out the fire, you’re going to need to learn how to operate the fire hose.

Let’s get geeky for a moment and review how the stress response system works.

Artist Credit: Holly Spence Fisher

When Pain Perpetuates

Pain and stress, whether that’s emotional, physical or both - in my opinion, how do you really separate the two? - will activate your body’s stress response mechanisms in the same way. Pain in your genitals will kickstart the sympathetic nervous system (the fight, flight or freeze mechanism). 

Your genitals play a vital role in physiological basic needs (ahem, pooping, peeing and sex). Naturally, anything that is threatening this part of your body will sound your alarm bells. If the threat lingers, whether from lack of answers, continued distress and or ongoing pain, the stress response mechanisms will continue to send the fire trucks because the alarm bells keep on ringing, which can result in more mental distress, dis-ease and a sense of lacking control. This lack of control and uncertainty will perpetuate the stress response mechanisms in your body.

HPA: Your Survival System

The hypothalamus-pituitary-adrenal (HPA) axis parts live in the brain, brainstem, and on top of the kidneys (known as your adrenals).

Source: Butler, D.S. (2000) The Sensitive Nervous System. Adelaide, Australia: NOI Group Publications

Source: Butler, D.S. (2000) The Sensitive Nervous System. Adelaide, Australia: NOI Group Publications

These work together to keep you safe and are essential for survival. The HPA axis also links to areas of your brain related to memory, emotional regulation, motor response and more. This ‘survival circuit’ also communicates with your immune system and will respond in similar ways with certain immune-mediated chemical signals.

The adrenals (nestled on top of your kidneys) are important endocrine glands that secrete chemicals like adrenaline, noradrenaline, and cortisol, which are activated to release when the parts of the brain determine that you’re in imminent danger and need protection. This process is triggered by stressors like pain, thoughts, beliefs, injury, feelings, memories, an annoying boss, a bear chasing you... You catch my drift.

During times of distress, the hypothalamus, a small region of the brain responsible for releasing hormones, emotional regulation, and other physiological functions, ‘tickles’ its neighbor the pituitary gland, the ‘master’ endocrine gland responsible for managing the hormone systems, to release chemicals into the bloodstream, which activates the release of stress hormones from your kidneys.

I know what you’re thinking…. It’s complicated. And you’d be right.

Stress, Survival, and Support

Cortisol is one such stress hormone that you’re probably familiar with because it gets a bad rap. In reality, it’s an essential hormone for our defense mechanisms. Without it, we’d be toast!

In emergency situations, this hormone helps shut down activities unnecessary for survival, like inflammation, digestion, and reproductive function. (No time for pooping and sex when you’re running away from that bear!)

On the flip side, prolonged activation of the stress response mechanism may dampen the healing effects of cortisol and decrease healing times, alter tissue health, increase pain sensitivity, and eventually leap from being anti-inflammatory to pro-inflammatory.

The amygdala, a part of the brain that interprets fear, emotion, and learned experiences associated with negative stimuli and memories, is also influenced by the stress response mechanisms during times of anxiety and fear, which will stimulate cortisol release. Even the anticipation of a stressful event, threat, or pain can do this. Negative or threatening words, images or thoughts, same deal. 

The more this triggering happens, the more it becomes tried and true, forming fear-based memories and learned patterns that keep you feeling stuck in a negative feedback loop (HPA axis on overdrive).1

Told you it was complicated!

In part 2, we will continue exploring the body’s systems, focusing on the immune system in relation to persistent pain.

References

Hannibal, K., & Bishop, M. (2014). Chronic Stress, Cortisol Dysfunction, and Pain: A Psychoneuroendocrine Rationale for Stress Management in Pain Rehabilitation. Physical Therapy, 94(12), 1816-1825. doi:10.2522/ptj.20130597

This information is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a healthcare professional with any questions you may have regarding treatment, medications/supplements, or any medical diagnoses. This information is intended for educational purposes only and is in no way to substitute the advice of a licensed healthcare professional.