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Stress

Why Your Body Hurts During the Pandemic

Health problems and pain are exacerbated during periods of stress.

Andrea Piacquadio/Pexels
Pain is spiking during the pandemic.
Source: Andrea Piacquadio/Pexels

Key Points: Health problems including headaches and back pain are on the rise. Negative emotions can exacerbate pain, so it's important to develop effective strategies to cope with stress and anxiety.

As a pain expert, the question I get asked most is, “Do you treat physical pain or emotional pain?” My answer is always, “Yes!”

If you’re experiencing pain during this time of stress and sheltering—headaches, migraine, low back pain—you’re not alone. Pain is commonly triggered, and amplified, by negative emotions like stress, anxiety, anger, and depression. And that’s no coincidence: It’s biology.

Contrary to popular belief, emotions don’t just live in your head—they also come out in your body. Nervousness before a presentation creates "butterflies" in your stomach. Depression can make your limbs feel heavy, and make you walk and talk slowly. Fear makes your heart race, eyes widen, breath quicken, palms sweat, and body feel jittery. Anger can make your face hot, jaw clench, and muscles tighten.

Anxiety and stress—emotions commonly experienced during life events from pandemics to politics—also manifest physically, and in different ways for different people. While the human stress response evolved to protect you, it can also wreak havoc on your body—particularly when sustained over long periods of time. Anxiety and stress can trigger headaches, stomachaches, diarrhea, nausea, vomiting, muscle tension, back pain, chest pain, trouble breathing, dizziness, breakouts, hair loss, weight gain/loss, and a whole mess of other physical symptoms (Mayo, 2019).

It’s easy to attribute these issues to other causes, and we usually do! But there are multiple biological explanations for these physiological responses:

1. Stress hormones

When in a state of distress, the body releases the stress hormones adrenaline and cortisol into the bloodstream. These ready your body for an emergency, triggering the fight-or-flight response so that you can either flee the source of danger or fight it off.

This involves multiple involuntary changes: blood pressure goes up (which can trigger headaches and migraines), breathing becomes shallow (often resulting in light-headedness and dizziness), digestion halts and the Enteric Nervous System is disrupted (triggering stomachaches, nausea, vomiting, diarrhea, or constipation), blood rushes away from your extremities to your core (causing cold hands and feet), heart rate increases, and muscles tighten, including those in your back. These physiological changes can result in body pain from head to toe.

2. Brain changes

The neuroscience of pain helps explain why emotions impact the pain we feel, and why times of stress can be particularly painful. There’s a mechanism in your central nervous system, comprised of brain and spinal cord, that acts as a pain dial, operating much like the volume knob on your car stereo (Zoffness, 2020).

Many factors regulate pain volume, including stress, anxiety, and mood. When stress and anxiety are high, brain sites that regulate pain—including your cerebral cortex (the part of your brain responsible for thoughts) and limbic system (your brain's emotion center!)—send messages to your pain dial, turning pain volume up (Martucci & Mackey, 2018). This makes your body feel worse. The opposite is also true: when you’re calm and relaxed, experiencing positive emotions like joy and gratitude, the brain sends messages to the pain dial lowering pain volume, making pain feels less bad.

The conclusion: Pain, whether it's in your foot or in your jaw, is both physical and emotional, 100% of the time.

How to Change Pain

This doesn't mean that pain is "all in your head." But it does mean that, in order to regulate pain, we must find ways to regulate our emotions—particularly our stress, anxiety, and mood. If you’re one of the millions of people living with pain, it’s critical to connect brain with body, emotional with physical.

One way to do this is to identify coping mechanisms that help your body feel better. A list of effective strategies can be found here, which includes going outdoors, exercising, finding ways to safely be with friends, using relaxation and mindfulness techniques, and finding a therapist. Indeed, research shows that Cognitive Behavioral Therapy (CBT) is a particularly effective treatment for chronic pain, is non-addictive, and has zero side effects (Murphy et al 2020; Skelly et al 2018). CBT is even associated with reduced need for pain medications, including opioids (Garland et al, 2019). Pain workbooks like this one, rooted in science and research, also offer effective tools for pain management.

Pain is never a purely physical experience—it is always impacted by thoughts and emotions. This is good news for anyone experiencing pain and for anyone treating it: To change pain, we can target the brain in addition to the body.

This article is adapted from The Pain Management Workbook, a workbook for people living with pain and the healthcare providers who treat them.

To find a therapist, visit the Psychology Today Therapy Directory.

References

Zoffness, R. (2020). The Pain Management Workbook. New Harbinger Publications.

Garland, EL, Brintz, CE, et al. (2020). Mind-body therapies for opioid-treated pain: a systematic review and meta-analysis. JAMA internal medicine, 180(1), 91-105.

Martucci KT & Mackey SC. (2018). Neuroimaging of Pain: Human Evidence and Clinical Relevance of Central Nervous System Processes and Modulation. Anesthesiology: The Journal of the American Society of Anesthesiologists, 128(6): 1241-1254.

Murphy, J.L., Cordova, M. J., & Dedert, E. A. (2020). Cognitive behavioral therapy for chronic pain in veterans: Evidence for clinical effectiveness in a model program. Psychological Services. Advance online publication.

Skelly AC, Chou R, Dettori JR, et al. (2018). Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review. Rockville (MD): Agency for Healthcare Research and Quality (US); Report No.: 18-EHC013-EF. PMID: 30179389.

Scientific American (2010). Think Twice: How the Gut's "Second Brain" Influences Mood and Well-Being. https://www.scientificamerican.com/article/gut-second-brain/

Mayo Clinic (2019). Chronic Stress Puts Your Health at Risk. https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth…

Scientific American (2010). Think Twice: How the Gut's "Second Brain" Influences Mood and Well-Being. https://www.scientificamerican.com/article/gut-second-brain/

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