Hello web surfers! A lot of changes have occured in the last month that have left us in uncharted territory. Unfortunately many of us have had to change our work hours, find new ways to get groceries (let me know if you can throw me a roll of TP), and physically distance ourselves from each other in order to best stop the spread of COVID-19. We are all now experiencing some sort of stress, including financial, social, or mental. Because of this, we find ourselves with some degree of anxiety or fear.
If you are currently experiencing some kind of stress or anxiety, wouldn’t you like to know what it does to your nervous system, how it increases sensitivity to pain in your body, and what to do about it? If you are still reading this, I bet you do. 1 out of every 3 of us is experiencing some kind of persistent pain. I think you can relate to this, and I’d like to share what I have learned so that you can better understand the roles stress and pain play in your life.
Your nervous system is a very sophisticated part of your body. The nerves monitor your body and the surrounding environment to inform you and your brain of anything going on. Our nerves function much like an alarm system. This is better than any alarm system on the market (sorry to the home alarm sales people out there). If there is a danger message, such as stepping on a rusty nail, a message travels from the foot to the brain to let you know and encourage you to act on it by pulling it out. After you pull the nail out, the nerves should settle back down to their resting level of alertness, waiting for you to step on the next nail (hopefully you learned your lesson).
Now for some of us, this alarm system can be a little slow to calm down after pulling out the nail. The nerves can become extra sensitive for multiple reasons and can keep the alarm system turning on much earlier. Let us go back to our home alarm system example. Throwing a rock through the dining room window would definitely (hopefully) set it off. However, for some of us all it can take is a leaf blowing by the front door to activate the alarm. This means that the nerves send a danger message to the brain much earlier. Danger = pain response. Maybe our alarm system needs to be changed, but a better answer would be learning to decrease our sensitivity to potential threats.
I used to believe that pain was merely a biological process. After studying to become a therapeutic pain specialist, I felt that our Western medical system had incorrectly provided information to the public stating that the mind and body were separate and did not influence each other. I now believe that our belief system, prior experiences with pain, emotions, and thoughts all influence the pain response.
Back in my roaring twenties I worked as a waiter- a pretty clumsy one, but people always got their food hot and sometimes in their laps. Well, how did I know I was prone to bodily harm? After my PM shift, I would wake up the next morning, walk around and notice some achiness on my leg. Sure enough, after a brief inspection, I would see that a dark bruise was appearing. How the heck did that happen without me noticing? Was it because I was so distracted carrying dishes and apologizing for spilling food that I didn’t notice hitting the hard corner of the bar with my leg? You betcha.
The point of that story is to make sure the food industry is grateful that I no longer work as a waiter, and to illustrate that it is possible the brain decides when to create the pain response. There are also examples of how the extent of the injury does not relate to the degrees of pain experienced. Anyone see a long line out the door of the ER for people with paper cuts on their fingers? In my career as a physical therapist I’ve cried over a paper cut and yet seen people with hip fractures report 0/10 pain through their entire recovery. Pain is your brain’s way of stating how much protection it thinks you need based on the information received from your environment and your body.
Your pain is very real. I have no doubt about that, and I believe that your pain should be validated. However, I would like to introduce the idea that changing your beliefs about pain, your emotional response, and perceptions can all lower your sensitivity to pain. Let’s now return to our current situation in dealing with COVID-19. Since we have this high degree of uncertainty in our lives that is a source of stress to all of us, it is certainly feasible that we could have a heightened alarm system, and therefore be experiencing a higher level of pain. So, in order to change our pain levels, we can focus on the one thing we used to think did not influence pain at all: our thoughts (which ultimately influences our brain)
From this perspective, there are many different ways to reduce stress, or at least to modify our reaction to it. Research shows that reducing your stress response via mindfulness, meditation or breathwork can have significant reductions in pain versus use of opioids, and even decrease opioid cravings. This helps to turn down the pain volume, decreasing sensitivity to pain.
One example is breathwork using the 4,7,8 method. Breathe in through your nose for 4 seconds, pause for 7 seconds, and then exhale out your mouth for 8 seconds. You can do this for 3 rounds or more. This will help to reduce the stress response over time. Being consistent is the key. There are many other useful resources such as headspace, calm and other apps via app stores.
Special thanks to Dr. Adriann Louw and Dr. Rachel Zoffness for their knowledge and expertise
Stay tuned for my next blog entry with specific examples and resources on these methods, and other ways to manage your pain.
Dr. Ben Olivo, PT, DPT, TPS (Therapeutic Pain Specialist)