If you’ve been living with chronic pain for a while I don’t need to explain to you the impact that stress can have on your symptoms. The more you worry, the more uncertain you feel, the tenser you are, the higher the likelihood that your pain will flare up.
This relationship between stress and pain, often termed "Stress Intolerance," is a well-studied phenomenon. I am, however, not a fan of the term. It sounds as though a person who experiences an exacerbation of symptoms in times of stress simply is 'intolerant' to said stress. It subtly implies a lack of ability, or a lack of capacity to address, respond to and deal with both the symptoms (and their causes), as well as the stress (and its triggers).
In this article, let's delve into the silent assumptions that guide our actions and inactions and, more importantly, explore tangible tools and resources to empower you in times of pressure.
Breaking the Cycle Proactively
Firstly, it's crucial to realize that there is most certainly something that can be done about it! Too often we experience ourselves as a passive recipient of pain and stress, as though we are purely on the receiving end of it, undergoing it, and it’s all out of our control. This perception leads to the belief that all we can do is hope that the stressors and pain pass quickly (or get worked up if they don’t!).
As the pain flare-up start to consume our attention, our mood and our energy, we tend to feel even more disempowered to do anything about the cause of stress in our lives, and we enter a cycle where pain and stress reinforce each other. Using pain killers to suppress the symptoms and ‘muddle through’ is often the only avenue we can conceive is available to us to make it through the days or the weeks.
So, how can we start breaking this cycle?
A Holistic Approach to Pain
As a posture alignment specialist, I see pain not as an indication of damage or a burden that must be ‘managed’, but as a form of communication from the body. As long as the pain is not subsiding: we haven’t found the cause yet and aren’t yet moving in a direction that resolves the cause. When we try various methods to ‘make the pain go away’ and each of them fails to achieve that result, it’s not surprising that we conclude that there simply isn’t anything that can be done about it.
I would suggest, if that has been your experience, don’t despair! Pain symptoms can be tricky because the site of the pain is often not the cause of the pain. The more we tunnel vision on that sore neck, that sore shoulder, that sore knee, etc, the more we miss clues elsewhere in the body that are contributing to the faulty use of muscles and joints down the kinetic chain and... causing pain. Unless we adopt a holistic approach of the body, our attempts to resolve the pain may continue to be futile.
Stress Extravaganza
Now, to consider: if pain ‘under normal circumstances’ is the body asking for help, in times of stress, our body is SCREAMING OUT for help. When we respond to this pain by becoming more inactive, more passive, and going into a mode of waiting/hoping that things will get better on their own, we’re inadvertently moving in the opposite direction of pain relief. When life gets busy and stressful we tend to throw self-care out the window, when this is actually the time we need to ensure we take care of ourselves the most.
See, chronic pain means our bodies are always under a certain level of stress simply by virtue of not being able to function according to its own design. It’s always in a state of compromise and trying to get your attention and help to return to balance and proper function. When your body is in balance it is more resilient in times of stress. It doesn’t mean stress won’t affect you at all, but it means it won’t cause you such agony.
Practical Tools and Suggestions When Dealing with a Pain Flare-Up
So, if you’re experiencing a pain flare-up as a result of stress at the moment, here are some things you can do. No need to try them all. You can pick a few that look beneficial to you and give them a try unconditionally (i.e. without expecting a particular outcome). It’s especially important to be aware of thoughts such as ‘that won’t work’. Our thoughts and beliefs greatly inform our bodies and can be taken as instruction. (It’s not because we don’t always listen to our bodies that our bodies aren’t listening to us!) When we state ‘that won’t work’ - our body goes ‘okay, keep stress and pain levels up in spite of what you’re about to do, got it’.
Open mind... ready, set, go!
1. Do your Posture Menu
A Posture Menu is a series of exercises tailored to your particular postural alignment and symptoms. The sequence is designed to bring your body back into effective alignment so that your joints are sitting where they are supposed to sit and the correct muscles are used for every day movements.
If you already have a posture menu - make sure you keep doing it every day! Resist the inclination to skip your menu because life is getting busy and stressful. Instead, you want to be extra vigilant that you’re giving your body this essential TLC. If you find your body is not responding to your menu the way it usually does, indicate it to your posture alignment trainer! Stress can impact your posture and you might need to make adjustments to your menu.
If you don’t have a posture menu yet, please consider booking a session so I can create one with you. For folks in Panama who are uncertain about traveling to Coronado at this time due to road closures, I also offer remote sessions.
Here is a playlist with different posture alignment exercises that you can try out if you’re not sure if this is for you:
Link to view the playlist on Youtube: https://www.youtube.com/watch?v=LDJON_UeQs4&list=PLFovWD5xlLf9jn60KW_AGE5dedTjgxgGE&pp=iAQB
When trying these out, please remember to stop doing any exercises that trigger pain for you! Every posture menu is different and no one size fits all.
2. Practice Square Breathing
In addition to your posture menu, incorporating mindful breathing techniques can help with stress management. Stress has a way of tricking us into a sense of urgency where we start speeding up inside ourselves. Regardless of how fast we’re physically moving, our thoughts can start racing and we try to do too many things at once. Our emotional state in turn affects our breathing, muscle tension and blood pressure.
It’s important to build in moments where you consciously decide to slow down and re-regulate both mind and body. If you’re not familiar with breathing techniques, I can recommend square breathing, also called box breathing or the four-count breath.
It’s a simple yet powerful technique to calm your nervous system and bring you back to the present moment, in sync with your body. All you do is breathe in for 4 counts, hold your breath for 4 counts, breathe out for 4 counts and hold for 4 counts.
Link to the video on YouTube: https://www.youtube.com/watch?v=CfUGpJE1D9o
3. Adequate Rest and Sleep:
A lack of sleep and rest can exacerbate both stress and pain. Establishing a consistent sleep routine and ensuring adequate rest allows the body to recover and better cope with stress. If you’re someone who struggles with sleep, I understand that this is easier said than done. Here are a few resources you can consider using:
A sleep or meditation app
The word meditation often brings up specific images and connotations that has many people sigh or access a level of resistance. Let’s consider meditation a form of mind and brain training. In the same way that we need to eat, sleep and move to keep our bodies functioning well, we need to provide our minds with frameworks, tools and exercises to help us reflect, process information, release built up emotions, and so forth. If you have no experience with meditation, you can use one of the many sleep and meditation apps, such as Balance and Calm.
I suggest, though, if using an app at night, to listen to the meditations without looking at the screen. This brings me to my next suggestion:
Reduce blue light at night
We’re biologically hardwired to get sleepy in the dark in front of a fire. The blue lights of a screen can counter our circadian rythm’s cues and interfere with its natural balance. Implementing a cut-off time for screens can help your body prepare for sleep. Additionally, you can consider blue light blocking glasses to mimic the changes in light we would have naturally encountered at night, but that are often missing in our modern lifestyles.
A nice cup of tea to get you snoozy
Several teas are well-known for their relaxing effects, you might even have some already sitting in your cupboard. Teas that can help prepare your body for sleep are chamomile, valerian, lavendar (yes, lavendar tea!), kava root and lemon balm. Be aware of how your body responds to reading the different teas. If one of them calls out to you more than the others, take note, your body is always communicating with you!
4.Talk to someone
Both pain and stress can have an isolating effect on us. Rather than reaching out for support, we withdraw inside ourselves, trying to create a protective cocoon around us to weather the storm we perceive is going on around us. We forget that half the storm is taking place inside ourselves, and that by closing off, we are inadvertently locking it in. It is easy to feel as though our problems are our responsibility and because of that, we should not burden anyone else with them. While our problems are our responsibility, taking responsibility for them sometimes means talking to others to see how best to respond to them.
In my experience, when I resist talking to others and use the justification that I don’t want to burden them, it really is a way of hiding that I am wary of being vulnerable with others. And vulnerability can have consequences, so be specific in who you talk to. You actually will know who the best person is for you to speak with, someone that will hear you and offer their perspective, without judging or shaming. They might even have sprung to mind as you were reading this paragraph ;).
A little note of consideration when talking to others:
If you’ve ever been a listening ear to someone else’s problems, you know it can land heavily sometimes. Now and then we have a harder time processing what was shared with us, or we get caught up worrying about the person or keep on thinking of strategies and solutions for them. For this reason, I suggest, when you talk to someone about things that are bothering you: also give them an update after a day or so. This serves as a personal accountability point so that you are reminded not to simply ‘dump and run’ - but to use conversations with friends and family as a point of support to gain new perspective and then ACT to implement solutions based on these new insights. Secondly, letting your person know that you used a particular strategy and what the result was can open up a new conversation, or can simply provide closure, letting them know you’ve got this and all turned out well.
5. Start Journaling
This is a habit that may take some time to form, but can be an excellent way to place all that is moving inside of you onto paper or into a file so that you can look at it in front of you without all the thoughts, worries and fears buzzing around in perfect chaos within. Writing creates a space within us to better see what is actually preoccupying us, what we’re actually worried about and gives us the opportunity to reflect on, analyze and question those experiences. We can use fears as practical reference points to verify: is this a real danger? If so, what can I do to prevent it? Or, if this does come to pass, what can I do, how would I respond to such a challenge?
This application is a way of working with fears constructively, discharging the energy and taking back directive power. Instead of stress running the show, we hear ourselves out by listing all the fears, and then ground them into practical reality. The act of writing itself (while you might resist putting in the time) also forces you to slow down within yourself, which will help you to see your experiences for what they are, and what you can do about them - rather than these overwhelming and chaotic currents that you’re ever at the mercy of.
In Conclusion
The interplay between stress and chronic pain is undeniable, but a proactive, holistic approach can break this cycle. Communication—with yourself, with your body, and with others—is key. Both stress and pain require us to engage with the problem in order to find workable solutions. And they will both let us know in no uncertain terms if our solution is effective or not. Don’t take that as discouragement, but as feedback, as a guide. Keep on testing tools and reaching out to people who can help you find a path through the storm. In the long run, this will empower you to not only endure, but meet life's challenges with resilience and grace.
You’ve got this.
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