Research has shown that there is enhanced pain sensitivity to a variety of psychosocial stimuli; and both healthy and chronic pain patients are known to be susceptible to the painful fall-out from exposure to emotions. This is not surprising, as there is a close anatomic relationship between the brain's pain and emotion circuitry. In addition, pain causes an increase in activation of the sympathetic nervous system, a reduction in opioid pain inhibition, and the muscular reactivity in response to negative emotions can amplify pain. Psychologically, the presence of negative emotions risks bias in the processing of stimuli, in turn causing potentially crippling hypervigilance, symptom worry, somatization, and social withdrawal. It goes without saying that negative emotions are generally pain-amplifying.
There has been previous research demonstrating that negative emotions are felt with greater force in those suffering from fibromyalgia. Anger is a particularly potent pain amplifier, as research has shown it increases pain perception and apparently also physiologic reactions such as muscle tension. Recent research published in the journal "Arthritis Care & Research" last October found that women with and without fibromyalgia manifested increased pain in response to anger AND sadness; the greater the emotional reactivity, the greater the pain response.
Fibromyalgia has been described as a "sensitivity syndrome", as patients may respond with pain to stimuli that do not normally cause pain (this phenomenon termed "allodynia"). However, the data in the study just published shows that while women with fibromyalgia did indeed experience more pain in response to anger and sadness, both women with and without fibromyalgia showed emotion-related pain responses to electrical stimulation.
The burning question thus becomes: Is emotionally induced pain in fibromyalgia unique?
The researchers further discovered that greater anger reactivity, and to a lesser degree sadness reactivity, were associated with a more potent pain response, supporting the assumption that emotions can amplify pain. Considering the degree of pain experienced on a daily basis by the typical fibromyalgia patient, the negative emotions associated with such a chronic condition, and the omnipresence of anger and sadness in this cruel world, we all need to discover how to prevent anger-induced and sadness-induced pain amplification.
There is a need to acknowledge the inevitability and impact emotions have in the daily lives of those suffering from chronic pain---and those supposedly "well" individuals among us. Emotional sensitization of pain is a detrimental phenomenon that can be thwarted: Techniques such as relaxation therapy, cognitive reappraisal, and exercise all have their respective abilities to facilitate better emotional regulation.
Unfortunately, many patients and health care providers do not want to admit the presence of emotions when considering the symptoms and treatments of what so many view as a strictly physical affliction. This prejudice might make life a little easier (less appointments for the patient, less competition for the rheumatologist), but it is also making life a little worse.
