Stress is a normal part of life--it helps us adapt and learn so that we are more resilient. We have built-in coping mechanisms to handle stress, and the brain is pretty good at knowing what to do to help us survive. These mechanisms are meant to be short-lived responses to hopefully infrequent events, but when we experience stress for longer periods of time, these built-in mechanisms stay activated and can impact the digestive system, mood, blood pressure, and health in general. This article will touch on one other aspect of stress that applies to physical therapy: stress changes how we experience pain.
Fight or Flight, Rest and Digest
The built-in mechanism that helps us take on stress is the sympathetic nervous system, which is often referred to as the “fight or flight” response. Think about what would happen if you were chased by a lion: your heart rate goes up, blood goes to the muscles, glucose is mobilized for energy, and your pupils dilate.
After a hopefully short sprint to safety, your muscles relax, your heart and blood pressure eventually go down, and you breathe a deep sigh of relief! Once the stressful event is over, your system shifts to promote healing, digestion, good immune function, and growth--a state called “rest and digest.” These two systems, the “fight or flight” (sympathetic) and “rest and digest” (parasympathetic), keep you in balance.
Getting the heart racing and muscles ready for action doesn’t just happen with the extreme example of running from a lion. The fight or flight response is also activated with anticipation or fear, experiencing physical pain, or enduring psychological stressors (a metaphorical lion). These stressors likely feel more relevant than a lion, but the effects can be similar whether you are trying to run to safety, get through a public presentation, or maybe even read the morning headlines.
Chronic stress
Experiencing stress over a long period of time means that the body is flooded with hormones, notably adrenaline and cortisol. When too much cortisol is in the system, changes in the immune system can contribute to widespread inflammation. It can also lead to mood changes, memory issues, fatigue, headaches, food cravings, and heart disease. And for the pain part: chronic stress can provoke or intensify pain, even without tissue damage!
How is that even possible? The stress response is meant to protect us, and during prolonged stress, the nervous system becomes so sensitive that it will let us know when anything changes--even changes that aren’t necessarily a real threat. This could be experienced as an old injury that is talking to you again, or maybe that little motion that seems harmless suddenly triggers back pain. Additionally, immune system changes and increased sensitivity have been shown to increase symptoms of arthritis, sciatica, migraines, and fibromyalgia.
You are resilient!
Before you feel stressed about how much stress there is right now, be assured that you are resilient and adaptable! Learning skills to slow the “fight or flight” response is so important during times of stress. Physical activity, social support, good sleep, healthy food, relaxation exercises, and the support of your mental and physical health providers are all important for thriving even in the midst of everything that is going on.
We are here with you to get through this, whether it’s addressing muscle tension, treating an injury to get you back to your usual activities, reviewing your workstation at home, or just making sure you have the resources you need to stay healthy. Now is the time to prioritize self-care and become more resilient to stress!