understanding your pain

Chronic Pain and Chronic Stress: Why It All Hurts

Chronic pain doesnt only make you more sensitive to physical painit can make you more sensitive to any kind of physical, emotional, or social stress. This increased sensitivity is also thanks to neuroplasticity. Each pain experience that triggers a stress response strengthens the stress response. Repeated pain experience leads to increased sensitivity of the areas of the brain that detect not only pain sensations but all kinds of conflict and threat (Zhuo 2007; Goncalves et al. 2008). This type of learning may play a large role in how chronic physical pain can develop into chronic emotional suffering, including anxiety disorders and depression. Not only does chronic pain make you more susceptible to chronic stress, but chronic stress can make you more sensitive to physical pain (Lariviere and Melzack 2000). The physiological changes of the stress response (including inflammation and arousal) provide the perfect learning environment for the mind and body, increasing the chance that pain will become persistent (Finestone, Alfeeli, and Fisher 2008). Chronic stress can therefore lead to the same changes to the nervous system as physical pain experience: threat detectors in the body become more sensitive, the nervous system more eager to pass those threat signals to the brain, and the brain more likely to interpret sensations as painful (Tracey and Mantyh 2007). If its getting hard for you to keep pain and stress separate in your mind, guess what: your nervous system has the same trouble. Because pain and stress are both survival systems, and because they so often go together, the nervous system can start to treat all threatsphysical, emotional, financial, social, and so onlike physical pain. Every time you have a pain response, your brain is building links between the many different sensations, thoughts, emotions, and cues in your environment that go along with your experience of pain. When these links are strong, anything your brain associates with physical painstress, anger, lack of sleep, the memory of pain, worries about the future, and so oncan trigger a full protective pain response: sensations, suffering, and all. A pain response can even be triggered by threats that have nothing to do with past pain or your body, such as stress at work or a fight with a family member. Even more surprisingly, psychological threats can trigger pain-inducing changes to the body. For example, stress has been found to trigger a unique pattern of muscle tension in people with chronic lower back pain (Glombiewski, Tersek, and Rief 2008). Contrary to the typical pain response, chronic physical pain can start in the brain and work its way to the rest of the body. The most important take-home point from all of this research is that stress is a big part of chronic pain. It is both a consequence and cause of pain andfor most peoplea chronic condition of its own. For this reason, learning how to reduce stress will be one of the most important steps you take in preventing and coping with chronic pain. Many of the things that reduce stress, such as a sense of control, social support, and meditation, will also reduce physical pain. Focusing on these things can be even more effective for chronic pain than trying to figure out what is wrong with the body and how to fix it.

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yoga for pain relief

reasons to be hopeful
Despite what sounds like a heavy dose of bad news about chronic pain, there are two very big reasons to be hopeful. The first is that your mind and body have built-in healing responses that are just as powerful as their protective pain-and-stress responses. These healing responses include the bodys natural pain-suppressing systems, the relaxation response, and positive emotions like joy and gratitude. You can learn to activate these responses to counter the effects of pain and stress and help the body recover from injury and illness. The second reason for hope is that learning is lifelong, and none of the changes youve learned have to be permanent. Sensitivity to pain and stress can become resilience. Neuroplasticity can be harnessed for healing. Your mind and body have learned how to do chronic pain, and your job is to teach it something new. These two reasons for hope are what the rest of this book is about. You now have a better understanding of the factors contributing to chronic pain, but the most important information is yet to come. You will learn more about each of these healing responses in the chapters that follow, with clear guidance on how to use them to reduce your suffering and heal your pain.

retraining the mind and body with yoga

The best way to unlearn chronic stress and pain responses is to give the mind and body new, healthier responses to practice. That is exactly what you will learn in this book: yoga practices that teach you how to choose health and well-being. In chapter 2, youll learn why yoga is such a promising approach for unlearning chronic pain. In short, yoga is a comprehensive mind-body system that provides tools to address every aspect of the pain response. There are yoga practices for relaxation, reducing stress, dealing with difficult emotions, examining your thoughts and beliefs about pain, and training the mind to be less reactive to painful sensations. Yoga will teach you how to use your mind as a resource for healing, instead of feeling at the mercy of an unpredictable body. Yoga will also give you a clear way to take care of your body and teach you how to take charge of your experience even when you are in pain. By helping you transform chronic pain-and-stress responses into chronic healing responses of mind and body, yoga will do more than reduce your suffering of chronic pain. It will give you greater strength, courage, and joy in all areas of your life.

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