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Often too little credence has been given to stress control of pain management and yet biologically it is essential tool in fighting pain.

If stress is left unchecked or unattended to - all the pain meds in the world will not help. That is why in addition to appropriate and adequate medication - for pain and spasm control, stress reduction and management needs to be included as a holistic approach.

Fight/Flight Response to Pain

When pain hits, it immediately sets up a response designed for protection - e.g.: to near to a flame you are burned.... arm says ouch brain says 'run away'.... without pain, we would do ourselves severe injury by not protecting or removing ourselves from harmful objects.

Unfortunately, with chronic pain, we have that same 'fight or flight' response repeatedly...lol..I have even said to my body "ok I get the message already stop hurting!"

There are two components to the fight or flight response....one is the automatic tension to muscles and two is the release of norepinephrine. Over a period of time, both these factors lead to a state of both mental and physical exhaustion.....Additionally a tensed muscle aggravates nerve endings or even making the muscles themselves more painful and sensitive...thus increasing the pain more still.

The fight or flight response can also lead to high levels of anxiety, restlessness and discomfort. Unfortunately, due to lack of mobility, the ability to work off the anxiety and reduce stress and return the body to a state of balance is limited.

Also, damage nerve endings can in fact regrow and attach to other nerves increasing sensitivity, so that touch even light touch elsewhere on the body will trigger a pain response.

Exhaustion is also linked with depression or depressed mood, which not only increases pain, but it also, restricts serotonin which is the body's natural defense or mood enhancer.

The sleeplessness which follows also exhausts the body's supply of endorphins - this is a naturally occurring chemical to combat pain - it is akin to opiate....often when we are truly exhausted we cry....crying stimulates the release of endorphins - that is why we can 'feel good' or euphoric after a good cry....

Finally, pain anywhere for any length of time results in guarding...this is where the posture is altered...movement stilted to try to 'protect' what hurts...in my case it means my whole body tries to protect itself ending up with even more pain and stiffness!

This sets the cycle going again.... pain - stress - increase pain = increase stress and so on.

So my friends...the need for learning biofeedback, relaxation techniques, stress management NEEDS to be used in conjunction with pain meds....

Over time and constant practice, one learns to recognize the early trigger symptoms of the body...so you can intervene before it begins to escalate....

it cannot work entirely by itself - although I have seen self hypnosis used to the point where pain meds are decreased dramatically.

It is best used in conjunction with meds, because if you can help stabilize and/or lower the pain to the manageable level...it is easier for the person to want to try to relax...

my 'mini- education series' here is used to help people to understand the process to assist the meds to work...most meds are blockers of one sort or another or they are enhancers to the neurotransmitters etc...

This is also why good anti-spas meds and accurate dosage is soooo important...the continuous spasms of muscles set the pain cycle off as well because of the tightening and or straining of contracted muscles...

Also, passive and where possible active massage and physical therapy helps to prevent atrophy but also where possible strengthens 'usable' muscles to enable us to do the things we need to do more easily...therefore lessening the load on effected muscles and guarded muscles.

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