THE IMPACT OF STRESS ON PAIN
All of us experience stress to varying degrees, however it is often poorly managed and understood – especially when it comes to our musculoskeletal health. All pain is a production of our central nervous system (CNS – brain and spinal cord), and stress (along with poor sleep, fatigue, illness etc.) is a significant sensitiser of our CNS. This means that stress can directly contribute to, or be a causative factor in the pain that we feel.
There is now a lot of published research on this topic, which reinforces the importance of managing stress when dealing with physical injuries:
*When injured, stress can slow healing by up to a massive 60% (Alford, 2006).
*Stress may reduce the response to training (Ruuska et al., 2012), and stress decreases short-term muscle recovery after resistance exercise (Stults-Kolehmainen & Bartholomew, 2012) – and thus also the response to rehabilitation.
*A recent meta-analysis shows us quality evidence that stress has a high correlation with injury rates, and psychological interventions can influence injury risk (Ivarsson et al., 2017).
It is therefore vital that in the world of physiotherapy and rehabilitation that we are strongly considering stress levels as an important factor in recovery from injury. Interventions for musculoskeletal injuries or pain need to be wholistic, and may require a psychological component as well as your standard mix of manual therapy and exercise.
Chris Bryceson
B. Health Sciences (Physio), APAM
CB Physiotherapy