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Is There a Link Between Prolonged Psychological Stress And Physical Pain?

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Featured Image of the ocean near the beach in the sun taken by myself. 

Dear Pain Matters blog readers,

Prolonged psychological stress can perpetuate chronic pain in some patients, while other people may be prone to chronic inflammatory diseases including cardiovascular disease, type II diabetes, depression, autoimmune diseases, upper respiratory infections and poor wound healing ability.

Immune cells are normally very sensitive to circulating stress hormones (glucocorticoids including cortisol), and as such, are usually able to shut down the pro-inflammatory response in the presence of glucocorticoids.

Chronic psychological stress can reduce the circulating stress hormone’s ability to interact with its receptor leading to glucocorticoid receptor resistance (GCR).

Repeated and ongoing exposure to a long-term threatening (real or imagined) and stressful experience can lead to insufficient glucocorticoid regulation (i.e. GCR), that in turn can lead to:

  • Insufficient control over the inflammatory response towards an infection;
  • Increased duration and/or intensity of the pro-inflammatory response; and
  • Increased pain levels and other signs and symptoms of chronic diseases.  

Studies have shown that some chronic stress sufferers (e.g. parents of children with cancer, spouses of patients with brain cancer and lonely people) present with GCR (Cohen et al, 2012).

Other Biomechanisms that Influence the Pro-Inflammatory Response and its Key Role in Maintaining Chronic Pain and Inflammation-Based Diseases:

See this Blog Post for more information:

https://painmatters.wordpress.com/2014/11/13/can-vagus-nerve-stimulation-decrease-inflammation-hence-reduce-inflammatory-pain-in-some-chronic-pain-patients/

What Can Done To Reduce Prolonged Psychological Stress?:

Steps must urgently be taken to reduce repeated and ongoing exposure to a prolonged threatening (real or imagined) and stressful experience.

This brings us to all those therapies that may induce the ‘relaxation response’ and/or lead one to a calmer disposition including:

Summary:

Any therapy that can induce the ‘relaxation response’ is key to diverting attention away from repeated and ongoing psychological stress.

This will strengthen the immune cells’ ability to interact with circulating stress hormones (glucocorticoids including cortisol) and shut down an exaggerated pro-inflammatory response.

Conventional pharmacological treatment also plays an important role in reducing excessive inflammation.  The effectiveness of pharmacological drugs may be further enhanced by the body’s ‘relaxation response’, leading to lower drug dosages and fewer adverse effects.

The body’s innate ability to properly control a pro-inflammatory response is key to warding off chronic pain and disease.

Sabina Walker

“Sedare dolorem divinum opus est”
“It is divine to alleviate pain”

Galen, 130-200 C.E.

REFERENCES:

Media

(1) Study Finds Link Between Stress And Physical Pain

Huffington Post (03 April 2012)

http://www.huffingtonpost.co.uk/2012/04/03/pain-stress-link-found_n_1398767.html

Book

(2) Clynes, Manfred

Sentics: The Touch of Emotions

250 pp, Doubleday/Anchor, New York, 1977

http://senticcycles.org/home/sentics/articles/sentics.pdf – Chapter 9 only

Peer-Reviewed Paper

(3) Cohen S, Janicki-Deverts D, Doyle WJ, et al.

Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk.

Proceedings of the National Academy of Sciences of the United States of America. 2012;109(16):5995-5999.

doi:10.1073/pnas.1118355109.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3341031/