How Stress Affects Pain

At some point in our lives we have all been stressed. And at some point in our lives, we have all experienced pain. The inter-relationship of these two complex physiological events is incredibly interesting.

We can define stress as our body’s response to actual or perceived threat, although threat is an all-encompassing term here and can mean different things for different people.

Stress is normal and healthy. If your blood-pressure doesn’t increase when a lion starts chasing you, this would be very BAD for your health.

It is with too much stress, or for too long a time, that our health is affected. If your blood-pressure increases each time you need to leave the house, your cardiovascular system is going to struggle to cope.

The relationship between stress and disease is well documented. Stress has been related to stomach ulcers, cardiovascular disease, lowered immunity, and many more conditions.

Stress is very important because, although it is not really a disease in itself, it has many effects on your physiology which can exacerbate other problems.

But how does stress affect pain?

There are a few main ways in which experiencing stress can affect pain:

  1. Physical: Muscles clench for long periods when we are stressed
  2. Chemical: Certain chemical changes can make us more or less sensitive to pain, depending on how long we have been stressed for
  3. Emotional: Pain is affects us emotionally. If our emotional resilience is lowered by stress, pain can be worse.

Physical Effects of Stress

There is a lot of overlap between the physical, emotional and chemical effects of stress, but stress does have well-documented physical manifestations.

Grinding of teeth, clenching of fists, shrugging of shoulders and shaking are all common physical manifestations of stress.

Stress acts across your whole body, but the epicentre of its activity is your brain. Neurons light up all over the place when we are stressed.

One such part of the brain that experiences a huge amount of extra action when we are stressed is the limbic system.

The limbic system is a very old part of your brain that helps to regulate your body’s chemistry. It is a major driver of our emotions.

There are direct neurological connections from this part of the brain to the muscles in your face, neck and shoulders. Hence, facial expressions affect and are affected by emotion. And similarly, there is more activity in the muscles in your neck and shoulders when there is more activity your limbic system.

So if you have ever been told you have tight shoulders, your limbic system, and stress, may be partly to blame.

This physical effect of stress can be painful, with contracting muscles becoming sore and achy. The effect of this continual clenching is also to cause dysfunction of the joints in the neck, with some joints taking more load than usual and becoming irritated.

Jaw clenching can also predispose to arthritis of the jaw joint and headaches.

These physical manifestations of stress are common contributors of neck pain and headaches, but fortunately are often easily dealt with.

Using manual therapy to switch off muscles and restore normal movement to joints in the neck is very effective at treating pain.

Interestingly, the route to the limbic system is a two-way street. So relaxing muscles in the neck, shoulders and jaw can actually reduce activity in the limbic system, breaking the vicious cycle.

Who knew a trip to the chiropractor could ease stress??

Chemical Effects of Stress

This is a massive topic and, for the sake of sanity, will have to be abridged.

The first place to start with chemistry and stress is with a hormone called cortisol. Cortisol floods your body when you are under stress.

If you have just lost your arm on the battlefield, astronomical levels of cortisol tell your brain everything is fine and to just get out of there.

So cortisol is good for pain then?

Not exactly. Cortisol is beneficial short term, but after more than a few hours your body needs a break. If our stress response continues our ability to regulate the amount of cortisol circulating our body is affected. Long-term this has many negative health consequences, and may actually increase our sensitivity to pain.

Another important chemical effect of stress is the reduction in levels of serotonin. This neurotransmitter inhibits pain perception, and lack of it lowers your pain threshold. Abnormal serotonin levels affect your sleep patterns, which can increase stress, but also further disturbs your cortisol levels.

Finally, prolonged stress has been linked to the presence of a chemical called substance-P.

Substance-P is not terribly well understood, but we do know that it increases the excitability of pain-carrying nerves and is commonly found in patients with long-term pain and complex pain-disorders.


The cross-over between emotional and and chemical effects of stress is ubiquitous, since all emotions involve chemical changes in the brain.

But because pain is an emotional experience and not just a physical sensation, emotions associated stress can affect it.

Think heart-break for one. People experiencing deep grief describe a physical sensation. Stress can actually be painful.

A sense of helplessness and inability to cope can alter our perception of pain, as well as affecting our ability to do something about it.

Unfortunately, as well as stress bringing on these feelings and affecting pain levels, pain levels can also bring on negative emotions and stress.


Dealing with pain can be incredibly helpful in dealing with stress. Manual therapy, such as that offered by chiropractors, can have far reaching consequences, providing more than just short-term pain relief.

Exercise is also increasingly being viewed as a panacea with regards to both stress and pain management. Our chiropractors can help formulate safe and optimal exercise plans to get the most from physical activity.

This article is only a very brief and simplistic overview of how stress relates to pain, but it demonstrates that to look after yourself you must pay attention to all aspects of your health; physical, psychological, and physiological.