Stress—What a Pain!

C’mon! You know that treadmill of pain:  When you’re hurting, you think about your pain and thinking about pain makes you ache and obsess even more. And so on and so on.

The back-and-forth between physical pain and stress spins through several types of conditions and injuries, including arthritis, muscle tension, migraines, back pain, cancer and fibromyalgia, according to the Anxiety & Depression Association of America.

“Every type of pain can have a stress component. And chronic pain can lead to emotional stress,” says Moises Lustgarten, M.D., medical director of  Baptist Health Neuroscience Center’s Pain Management Program. “We treat all sorts of pain.”

Neck and back pain are the most common reasons for an office visit to a doctor or specialist, according to the National Institutes of Health. And every year, millions of people in the U.S., suffer from chronic pain that is severe and difficult to manage, according to federal data.

Here are more facts about pain and stress.

What triggers additional stress?

“There is a relationship between stress and pain because of the whole situation you are going through,” Dr. Lustgarten says. Lack of knowledge about your physical condition and treatment options can add to your pain; fears about addiction to painkillers or the inability to track down the right meds can also highjack your peace of mind.

Physical pain can create financial stress if you are unable to work and have trouble paying bills, he says. Your illness or condition can also disrupt family relationships and routines.

What are the treatment options for the combination of stress and pain?

Treatments vary:

  • Interventional pain management: Medication (steroids) can be injected into affected areas (joints, the spine or nerve tissue) to block the nerves that send pain signals to your brain. By muting your pain response, the medication enables your body to reset your pain meters and break the escalating cycle between pain and stress, Dr. Lustgarten says.
  • Medicine: To control pain and stress, your doctor might prescribe different meds, including anti-inflammatory pills, pain killers (opiods), muscle relaxers and anti-depressants.
  • Physical therapy: Manipulation, exercise and massage can lower the stereo volume of stress and pain. Other complementary treatments include yoga, relaxation techniques, cognitive behavioral therapy and acupuncture, according to the National Institutes of Health.
  • Lifestyle changes: Better diet, regular exercise and improved sleep habits can also provide relief from stress and pain, according to medical experts.
  • Surgery: When other treatments fail to deliver relief, your medical team may recommend surgery or implant a medical device programmed to deliver a steady drip of morphine or other pain medicine.
  • Why are anti-depressants used to treat physical pain?

    Fibromyalgia — a condition linked to generalized body aches and extreme fatigue — is often treated with antidepressants to increase neurotransmitters such as serotonin. (Neurotransmitters affect your moods, your ability to bounce back from difficulties and your response to pain.) Low levels of serotonin are linked to depression, anxiety and high sensitivity to pain.

    When should you consult a pain specialist?

    Back and neck pain are among the most common sources of pain, and you should call your physician if a dull ache or pain lasts for more than two weeks, Dr. Lustgarten says.  Seek medical attention immediately, if a dull ache is accompanied with severe weakness in your arms or legs, a fever, chills or the inability to move your bowels. Those are signs that you may have a compressed nerve, an infection or some other condition demanding immediate attention.

    “Your primary care physician may refer you to a pain specialist if your pain persists for three to six months despite medical treatment,” Dr. Lustgarten says. “A pain specialist can solve your pain puzzle and reduce your stress.”




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