Chronic Pain and Your Emotions: Is There A Connection?
Dr. Eric Viegas, ND
You’re in pain. You decide to go to your doctor to address it, but you feel like the physical approach used is lacking something specific to how you feel.
Pain is a very interesting sensation; it is highly individualized and subjective. The perception of pain can be limited or worsened by stress.
When our bodies encounter physical trauma, a damage to nerve fibres can result in physical pain. If you are suffering from depression, your mental health can worsen the physical pain. Social factors like isolation and loneliness can further complicate the picture of your pain.
So as you can see, your emotions and how you deal with them can affect how you experience your pain.
Fibromyalgia (FM) and Irritable Bowel Syndrome (IBS) are both conditions where people experience a high degree of pain and discomfort without obvious clinical or laboratory evidence to indicate damage to the affected areas. Also, FM and IBS may occur at the same time, further complicating treatment.
A recent theory called central sensitivity syndrome (CSS) attempts to explain the persistent pain felt from these conditions. CSS notes a hyper-excitement of the central nervous system (brain and spinal cord) rather than a direct issue with the affected areas. CSS may explain the emotional component of pain and the need for it to be addressed in chronic persistent pain syndromes (1).
Now let’s talk about feelings of fear and anxiety, common forms of stress response.
Fear is experienced when we encounter a threat, and it motivates defensive behaviours like running away to escape.
Anxiety is usually the anticipation of a threat and results in hyper-alertness and defensive responses.
Acutely, fear has the ability to decrease pain, while anxiety may increase it. Eventually, repeated experiences with fear may lead to anticipatory anxiety and persistent pain.
Positive emotions, on the other hand, are associated with pain relief. Dopamine is a neurotransmitter involved in the brain’s reward center and is triggered by stimulants like food, water, sex, and drugs. Dopamine makes us feel good by reducing anxiety and fear. As a result, addiction to substances that boost dopamine is often seen in people with chronic pain.
Interestingly, pleasant music may also trigger the dopamine reward center and suppress pain (2).
Pain is complex, and what works for one person’s pain may not work for you.
It is important to be able to identify and label your emotions if you deal with chronic pain, because a difficulty in experiencing, expressing, and describing emotional responses has been shown to be elevated in conditions like low back pain, fibromyalgia, and TMJ disorder. This emotional difficulty, called alexithymia, is often elevated in people with high levels of chronic pain (3).
So how can you move forward and address your emotional well being? A good way to start is to draw a picture of how you are feeling if labelling your emotions through spoken word or journalling is difficult.
Certain MDs, NDs, psychotherapists, counsellors, and other professional therapists use mindfulness based therapies to further help you work through emotional traumas that might be affecting your pain.
Expression of your emotions is helpful if done in a healthy way; perhaps writing, painting, yoga, exercise, singing or dancing may allow for a healthy expression of your emotions.
Local community support groups may also be helpful if addiction is a main factor numbing you from your emotions.
- Arendt-Nielsen L, Nie H, Laursen MB, Madeleine P, Simonsen OH, Graven-Nielsen T. Sensitization in patients with painful knee osteoarthritis. Pain 2010; 149: 573-581.
- Fields HL. Understanding how opioids contribute to reward and analgesia. Regional Anesthesia and Pain Medicine 2007; 32: 242-246.
- Lumley MA, Neely LC, Burger AJ. The assessment of alexithymia in medical settings: Implications for understanding and treating health problems. Journal of Personality Assessment 2007; 89: 230-246.