Our understanding of pain is evolving, and with it our interventions. More and more doctors are starting to look beyond the mechanical functions of our tissues and talk about how life stressors, both past and present, can come into play in your recovery. Frankly, it sounds a lot like mumbo jumbo and voodoo, but the science behind it is actually remarkably sensible and explains a lot of things that we already know to be true on a much better level.
Let’s start with what pain is, or more specifically what it isn’t. Pain is actually not what we long thought: an input from our nervous system. It’s actually the output of our brain processing a stimulus and determining that this thing may be dangerous and should be avoided. It’s why over time welders are able to tolerate higher heat levels without withdrawing their hands, why martial artists can take progressively harder and harder hits to their shins and forearms, why runners can go further and further without their legs screaming at them the next day. As our body learns that a stimulus is not going to actually damage us, it refines its approach to telling us what hurts, what to avoid. Pain is an excellent way for the unconscious portions of our brains to tell the conscious ones not to put stress through a tissue, whether work, pressure, temperature, or something else. Did a tendon just go through a sudden, hard pull? Great, signal the brain not to put pressure through it for a bit until we can determine if it is truly safe or not with some experimentation. It’s why when coaches tell their athletes to walk it off after something hurts, sometimes it works! It’s why more and more doctors are discouraging bed rest after a back strain, and asking patients to try and get back to their normal activities ASAP! If our body tries out the body part and finds that it does not continue to get back noxious signals, it knows it can go right back to functioning as normal.
That protective response our body has is known by many practitioners as “guarding.” Local tissues will be held at higher tone to avoid excessive movements that the brain thinks could be damaging if progressed to too quickly. Excess tendon load, a type of physical stress, is a common cause of this phenomenon. But beyond physical stress, mental and emotional stress can actually increase guarding as well!
When our body perceives a possible dangerous stimulus, the basis of the stress response in the body, it will often increase our physical guarding as well. This increases the activation of a lot of our muscles, and sometimes if this response stays around for a long time those muscles have a hard time turning back off in some sections. These constantly contracted areas of our muscles are often highly tender, very tight, and can radiate symptoms, and you may better know them as knots! It makes a lot more sense why those knots appear right before a big presentation or after a lot of customer issues at work now, doesn’t it!
But the stress response system does something else important to the body to keep it alive: it makes our brain tune in more to things that it perceives as possible stressors. That’s right, that means that being under any kind of stress actually increases how much our brain might pay attention to areas of the body it has labeled as in pain, essentially literally increasing the amount of pain perceived from any real or potential injury.
To make matters worse, that increase in pain is a literal increase in stressors, which can further increase that stress focus on the area, compounding pain by simply having pain!
Yikes! So what can we do about this? Well obviously addressing the causes of our daily stressors can be big load off what our brain is under. Gradually exposing areas of the body to light physical stressors so that they can perceive these stimuli as less dangerous can help the physicality of it all. Biggest yet? Learned how to control our stress response is huge. Breathing techniques, mindfulness activities like body scans, and performing our routines in a safe and self controlled environment, can increase the activation of the parts of our nervous system that allow the body to break a stress cycle, and in doing so can actually alleviate, or sometimes even eliminate pain!