Stress Management, Well-being and Self-Care

Stress and Chronic Pain (Part 3)

Stress and Chronic Pain (Part 3)

by James Porter September 09, 2020

This is a four-part series about the relationship between stress and pain. I was inspired to write this series, after re-watching the movie FREE SOLO about Alex Honnold, who climbs a 3000 foot shear cliff with no ropes or safety equipment. I was so stressed out watching this movie (even though I KNEW he would make it to the top) that by end of it, my shoulders were so tight, I was wincing in pain, every time I lifted a glass of water to my mouth.

You can read Part 1 here and Part 2 here

One of the most interesting medical studies I’ve ever read looked at how pain medications were handed out in a hospital setting. In this study the patients were divided into two groups. One group had their pain medication on a bedside table. The other group had to ask the nurse for it. The results of this study really surprised me.

The group that had to ask the nurse for it, took more pain medication than the group that could take it anytime they wanted.* While these results surprised me at first, the more I thought about it, the more it made perfect sense. The group that had their pain meds handy, were in complete control. They could opt to endure the pain longer, knowing that they could take a pill anytime they wanted. Or, it could be that having more control, they experienced less pain.

People who feel like they are in the driver’s seat of their lives (thus having an “internal locus of control”) experience less stress. People who feel like someone else is in the driver’s seat of their lives – (thus having an “external locus of control”) experience more stress. So that explains the relationship between control and stress but what about the relationship between stress and pain?

In an article published online by Psychology Today, Susanne Babbel, Ph.D., writes:

“Many people are already familiar with the fact that emotional stress can lead to stomachaches, irritable bowel syndrome, and headaches, but might not know that it can also cause other physical complaints and even chronic pain. One logical reason for this: Studies have found that the more anxious and stressed people are, the more tense and constricted their muscles are, causing the muscles to become fatigued and inefficient over time.”

No matter where you may be feeling pain (locally) in your body, that pain is registering in your brain. And it’s the pain receptors in the brain where your pain is usually treated. Thus, the psychological aspects of pain – the story we tell ourselves about the pain – often contributes to the overall sense of pain we feel.

So, the people in the study who had complete control over how much pain medication they could take and how often, are most likely going to be telling themselves a very different story than those who had no control. And that lack-of-control-story can greatly add to one’s stress and consequently one’s pain.

When mindfulness expert and author, Jon Kabat-Zinn, founded the very first mindfulness Clinic at the University of Massachusetts Medical Center, its primary purpose was to help patients with chronic pain. As Kabat-Zinn tells it, “when doctors at the hospital reached a dead end trying to treat patients dealing with chronic pain, they’d often say ‘why don’t you try the mindfulness clinic, they might be able to help you.’” And as mindfulness practitioners like to point out, it’s often the “story” you tell yourself about the pain that is doing as much damage as the original source of the pain itself.

This leads perfectly into the mindfulness story of the two arrows, which I will save for the final installment of this series on pain and stress.

*I first came across this study decades ago in an article written by Norman Cousins, who was, early in his career, the editor in chief of the Saturday Evening Post, then later a best-selling author (Anatomy of an Illness From the Perspective of a Patient), and finally a pioneer in mind-body medicine. Without ANY medical degrees what-so-ever, he finished out his career as a professor in the Medical School at UCLA.

James Porter
James Porter