Stress, Pain and Healing

What is stress? And what has it got to do with pain and healing? Keep reading to find out….

What is stress?

Our brain keeps our bodily systems in a delicate balance. For example, our internal body temperature is kept at 37 degrees – if we get too hot, we sweat to cool ourselves down, if we get too cold we shiver to warm ourselves up. Blood sugar, blood pressure, calcium levels are all tightly regulated to maintain balance.  

At its most basic level, stress is simply the body’s reaction to any change that disturbs this delicate balance. Anything that causes a change is known as a ‘stressor’.

Stress can be good (also called eustress), or bad (distress).  For example, just the right amount of exercise will provide a good stress on the body and cause it to adapt and become stronger, but too much exercise will overstress the body causing it to eventually breakdown.

But it’s not just the stressor itself that dictate whether it will be healthful or harmful. Your own perception of that stressor will also direct whether it is ‘good’ or ‘bad’. The stressor may be exactly the same but two different people may have to completely different responses.  Take public speaking for example, for one person this could be extremely stressful leading to fear and anxiety whilst for another it may be something that they really enjoy.

What happens when you are stressed?

A perceived stress causes an activation of the stress response or the “fight or flight response”. This is a physiological response and triggers the release of stress hormones such as cortisol and adrenaline resulting in elevations in heart rate, blood pressure, sweating and breathing rate.

The stress response is a normal physical and mental reaction to life experiences. This response is designed to protect your body in an emergency by preparing you to react quickly. For short-term situations, stress can be helpful and beneficial. But, if your stress repsonse is maintained for long periods it can start to take a toll on your health. Chronic stress can cause a variety of symptoms and affect your overall well-being. Symptoms of chronic stress include:

• Anxiety
• Depression
• Headaches
• Insomnia

Although stressors can take a variety of forms such as food, temperature and exercise, psychological stress is thought to have the biggest impact on the stress response.

“Overwhelmingly, it is psychological stress rather than physiological stress which has the capacity to elevate and maintain the stress response chronically causing disease consequences“

Sapolsky R.M (2007)

The effect of stress is not to be underestimated. Consider for example that there was a 25% increase in heart attacks admissions in London on the day of the match when England lost to Argentina in penalty shootout during 1988 World Cup…

So what does stress have to do with pain and healing?

Not only does stress play a substantial role in a number of chronic diseases but it has also been found to have a profound effect on pain, healing and recovery from injury.

The effect of psychological stress on healing has been known for some time. As far back as 1995 researchers examined the effects of the chronic stress of caregiving for a loved one with Alzheimer’s disease or other dementia. It was found that caregivers took an average of 24% longer to heal a small standardized wound.

Even milder levels of stress, such as school exams, were shown to have a profound effect of healing. In a sample of 11 dental students, standardised wounds placed in the hard palate healed an average of 40% more slowly during an examination period than during a holiday period. This effect was remarkably reliable: every student in the study healed more slowly during exams than during their holiday.

Higher stress scores are also associated with increased pain. The authors suggest that this is most likely a two-way relationship exists where pain exacerbates stress and stress exacerbates pain.

But not only do higher stress levels increase pain and slow healing, but more recently it has been found that higher stress levels increase the risk of sustaining an injury the first place. Researchers found that the odds of an injury occuring during weeks of high academic stress were nearly twice as high than during weeks of low academic stress.

The good news is, this risk can likely be mitigated – Studies looking at injury prevention showed a decreased injury rate in the treatment groups compared to control groups. Other Clinical trials have also shown that stress reduction techniques lead to improved wound healing after injury.

Stress Reduction Techniques

The following are 3 simple methods that have been shown in the research to effectively reduce stress which will ultimately help to improve your recovery.

1) The Relaxation Response Breathing Exercise

Click here to learn more

2) Mindfulness Mediation

Headspace describes mindfulness as:

“the quality of being present and fully engaged with whatever we’re doing at the moment — free from distraction or judgment, and aware of our thoughts and feelings without getting caught up in them.”

Headspace

Just like the skill of self-defence can be trained in a gym so it can be used in the outside world,  the skills of mindfulness can be trained through meditation so that it can be applied to everyday life.

Forms of mindfulness meditation vary but may involve:

• Breathing practice
• Mental imagery
• Awareness of body and mind, and
• Muscle relaxation

There are many mindfulness meditations programs.  One of the most researched programs is mindfulness-based stress reduction (MBSR). MBSR is a formal 8-week program incorporating mindfulness techniques to promote health for people with stress, chronic pain, and illness. Research on MBSR has shown reductions in pain along with improved attention, improved quality of sleep, and improved quality of life. MBSR is usually taught in weekly group classes but there are also now many websites offering online MBSR Courses.

You can also learn and practice mindfulness through the use of mobile Apps. Headspace and Calm are two popular apps that teach mindfulness-based mediation.

3) Exercise

Exercise is another effective stress reduction technique. In fact, a recent randomised control trial showed that physical exercise was equally effective as mindfulness meditation in reducing stress and its related symptoms. Other forms of exercise such as Yoga or Tai Chi have also been found to effective at reducing stress levels.

Stress Reduction at Dynamic Health

Deep Tissue Massage

Deep tissue massage is a specific form of massage that works on the deep layers of the muscles and other soft tissues. As well as an effective treatment for a number of pain syndromes, research has shown that deep tissue massage can help to reduce stress and anxiety.

 

 

Reflexology

Reflexology is a type of bodywork that involves applying different amounts of pressure to the feet. The theory of reflexology is that all the systems and organs of the whole body are mirrored or reflected in smaller extremity areas, such as the feet. Pressure of these areas stimulates the underlying peripheral nerves and thereby promotes a positive response in the corresponding area.  Several studies indicate that reflexology may reduce pain and psychological symptoms, such as stress and anxiety, and enhance relaxation and sleep.

 

 

Restorative Yoga

One antidote to stress is relaxation and restorative yoga delivers exactly that.

Restorative yoga is a combination of supported passive poses and a focus on the breath.  Each pose is held from 2 to 15 mins allowing the body time to rest, renew and restore.  Props such as bolsters, blankets, blocks, pillows and chairs are used to support the body allowing for complete relaxation.  

The poses held promote healthy movement with gentle extension, flexion and twists. Attention is directed towards the breath to calm the nervous system and create a state of deep, restorative rest.  This practise can help to reduce symptoms of high stress such as anxiety, fatigue, insomnia, high blood pressure, migraines, back and neck pain and symptoms of menopause.

For more information about the restorative Yoga classes contact Carol Wood @
recrose180@hotmail.co.uk or 07797754944

Tai Chi

Originally developed for self-defence, tai chi has evolved into an elegant form of exercise. Often described as meditation in motion, tai chi promotes posture, breathing and relaxation through graceful flowing movements.

For more information and to book contact Richard on 07797722929.  

Related articles

• Overtraining
• Rainbow Breathing Exercise

References

• Sapolsky, R. M. (2007). Stress, stress-related disease, and emotional regulation.
• Carroll, D., Ebrahim, S., Tilling, K., Macleod, J., & Smith, G. D. (2002). Admissions for myocardial infarction and World Cup football: database survey. Bmj, 325(7378), 1439-1442.
• Kiecolt-Glaser, J. K., Marucha, P. T., Mercado, A. M., Malarkey, W. B., & Glaser, R. (1995). Slowing of wound healing by psychological stress. The Lancet, 346(8984), 1194-1196.
• Marucha, P. T., Kiecolt-Glaser, J. K., & Favagehi, M. (1998). Mucosal wound healing is impaired by examination stress. Psychosomatic medicine, 60(3), 362-365.
• White, R. S., Jiang, J., Hall, C. B., Katz, M. J., Zimmerman, M. E., Sliwinski, M., & Lipton, R. B. (2014). Higher perceived stress scale scores are associated with higher pain intensity and pain interference levels in older adults. Journal of the American Geriatrics Society, 62(12), 2350-2356.
• Ivarsson A, Johnson U, Andersen MB, et al. Psychosocial factors and sport injuries: meta-analyses for prediction and prevention. Sports Med 2017;47:353–65.
• Whitney, J.D., Heitkemper, M.M., 1999. Modifying perfusion, nutrition, and stress to promote wound healing in patients with acute wounds. Heart Lung 28, 123–133.

• Holden-Lund, C., 1988. Effects of relaxation with guided imagery on surgical stress and wound healing. Res. Nurs. Health11, 235–244

• Field, T., Peck, M., Krugman, S., Tuchel, T., Schanberg, S.,Kuhn, C., Burman, I., 1998. Burn injuries benefit from massage therapy. J. Burn Care Rehabil. 19, 241–244.

• van der Zwan, J. E., de Vente, W., Huizink, A. C., Bögels, S. M., & de Bruin, E. I. (2015). Physical activity, mindfulness meditation, or heart rate variability biofeedback for stress reduction: a randomized controlled trial. Applied psychophysiology and biofeedback, 40(4), 257-268.
• Zou, L., Sasaki, J. E., Wei, G. X., Huang, T., Yeung, A. S., Neto, O. B., … & Hui, S. S. C. (2018). Effects of mind–body exercises (Tai Chi/Yoga) on heart rate variability parameters and perceived stress: A systematic review with meta-analysis of randomized controlled trials. Journal of clinical medicine, 7(11), 404.

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‘Stress, Pain and Healing’ was written by Steffen Toates. Steffen is a chiropractor at Dynamic Health Chiropractic in Jersey CI. For more information about Steffen click here.

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