How Do Our Emotions Affect Pain and What Can We Do About It?
Have you ever noticed that pain or unpleasant sensations can be increased when you are feeling stressed or upset? This is due to the fact that pain is deeply connected to our emotions.
Pain is defined by the International Association for the Study of Pain as an “unpleasant sensory and emotional experience associated with actual or potential tissue damage”. Therefore, emotions affect pain in body and mind, as well as influence the experience of pain.
As a physiotherapist, I often educate my patients on this definition of pain and how stress and emotions can affect their experience. I have also experienced this first hand which gave me a better understanding of this relationship.
Last summer, when I was exercising at the gym I had over-exerted myself and had experienced intense low-back pain for the first time. I rested for a few days but the pain did not seem to go away. As the pain persisted I became more worried about it. When I returned to work, I had a particularly stressful day and found that my back pain was increasing. I decided to book myself in for an assessment with another physiotherapist. She completed a thorough assessment and re-assured me that my injury was minor and that it would resolve with some activity modification and exercise. She reminded me of the relationship that emotion has on our pain experience. As I reflected on the busy and stressful day that I had, I realized that my emotions of worry and stress influenced the way that I was experiencing back pain.
To address and treat pain as a sensory and emotional experience, we need to take a multi-faceted approach. We need to address the impact on the body through exercise and we also need to address our mind and emotions, as this can impact the intensity of pain and how we perceive it.
What ways can we address our emotions and the way that we feel?
We can use mindfulness meditation to help relax our body and reduce stress. A study completed by Zeidan et al, (2015) determined that mindfulness meditation decreased the sensation of pain by 27% and emotional unpleasantness by 44%. Those completing mindfulness in this study sat comfortably, focused on their breath, and let thoughts go without judgement for 20 minutes. This is something that we all could do on a regular basis.
Improving our sleep:
As per the World Health Organization, sleep allows us to control our emotions, socialize appropriately, and think rationally. One night of sleep deprivation can increase our body’s sensitivity and our levels of anxiety (Schuh-Hofer et al, 2013). Most people with persistent pain have disrupted sleep. We can improve our sleep quality in the following ways: going to bed and waking up at the same time every day, sleeping in a cool environment, avoiding naps during the day, regular exercise during the day, avoiding screens one hour before bed, and avoiding caffeine 6 hours before bedtime.
Continuing to be active and participate in activities that you enjoy:
Just because we experience pain does not mean that we have to stop all of our activities. It is important to continue with activities that are meaningful to you as this can affect our mood. For example, continuing with walking, running, yoga or strength training in a modified way, playing with your kids, and spending time with family and friends. If you are unsure how to modify your activities you should talk to a healthcare provider or physiotherapist, and they can guide you in the right direction!
Addressing worry and negative thoughts:
When we experience pain, it is common to worry about when it will end and how to manage it. However, this may lead to negative emotions that can be difficult to deal with. In these cases, it can be helpful to seek help from a mental health professional such as a psychologist or counsellor. It is important to talk to your healthcare providers about the way that you feel so that they can provide you with appropriate resources or refer you to get the help that you need.
Lastly, learning and understanding more about pain and the body – Knowledge is power! By talking to your healthcare providers you can learn more about how emotions affect pain. The more that we know about pain, the less scary it can be.
Alyssa Hanson, PT, MSc PT, BSc Kin (Hons.)
Zeidan, F. et al. (2015). Mindfulness Meditation-Based Pain Relief Employs Different Neural Mechanisms Than Placebo and Sham Mindfulness Meditation-Induced Analgesia. Journal of Neuroscience, 35 (46), 15307-15325, DOI: 10.1523/JNEUROSCI.2542-15.2015
Schuh-Hofer, S. et al. (2013). One night of total sleep deprivation promotes a state of generalized hyperalgesia: a surrogate pain model to study the relationship of insomnia and pain. Pain, 154 (9), 1613-1621, DOI: 10.1016/J.pain.2013.04.046