The Link Between Stress and Chronic Pain

Why Physical Pain Gets Worse with Stress

Have you ever noticed that your physical pain seems to flare up during particularly stressful times? Maybe your pelvic pain intensifies before a big presentation at work, or your IBS feels unbearable when you’re juggling too many responsibilities. You’re not imagining it: stress and physical pain are deeply connected. Understanding why this happens can help you break the cycle and take steps toward relief.

The Science Behind Stress and Pain

Stress activates your body’s fight-or-flight response, a survival mechanism designed to protect you in times of danger. When you’re stressed, your brain releases hormones like cortisol and adrenaline. These hormones trigger a cascade of physiological changes: your heart rate increases, your muscles tense, and your body becomes hyper-alert. While this response is helpful in short bursts, chronic stress keeps your body in a heightened state of tension, which can worsen physical pain.

For one, stress causes your muscles to tighten as part of the fight-or-flight response. Over time, this sustained tension can lead to pain, especially in areas already vulnerable, like your pelvis, neck, or lower back. Chronic stress can increase inflammation in your body. Research shows that heightened levels of inflammation are linked to many conditions, including endometriosis, pelvic pain, and other chronic health issues. Stress changes how your brain processes pain. When you’re under stress, your brain may become more sensitive to pain signals, amplifying even mild discomfort into something that feels overwhelming.

Stress doesn’t only affect your body; it also impacts your emotional well-being. Feeling overwhelmed, anxious, or emotionally drained can make physical pain feel worse. In addition, fear and catastrophic thinking can increase with pain conditions. When you’re stressed, it’s easy to spiral into thoughts like, “This pain will never get better,” which can increase your perception of pain.

Client Story: Overcoming Fear and Stress
Around Pelvic Pain

I’m sharing a client story (with permission and name changed) to illustrate how the therapeutic process can help with chronic pain. Emily had been living with chronic pelvic pain for years, and it seemed like every day was a battle. She had tried various treatments and therapies, but nothing seemed to bring lasting relief. What troubled her the most, however, was the constant anxiety surrounding her pain. Each time she felt a twinge or burning sensation, a wave of fear would flood over her. She would worry: What if this flare-up is worse than the last one? What if it never goes away?

In our sessions, we explored how Emily's fear of pain had become a significant source of stress in her life. She realized that the more she feared the pain, the more she would tense up in anticipation, which only made her pain worse. Her body was constantly on high alert, bracing for the worst, which created a vicious cycle. When Emily felt stressed or anxious, her nervous system would go into fight-or-flight mode, making her more sensitive to the pain and increasing the severity of her flare-ups.

We began focusing on learning about the nervous system, the window of tolerance, and calming techniques to help Emily relax when the pain started to creep in. I also introduced her to the concept of pain catastrophizing—the tendency to imagine the worst possible scenario—and how it could actually contribute to an increase in pain. Emily was surprised to learn that by reducing her fear and giving herself permission to stay present and grounded in the moment, she could break the cycle of pain and fear. We also used EMDR to desensitize her response to triggers from earlier in her life. This helped reduce emotional triggers in her everyday life, which in turn helped her anxiety and nervous system. Then, we processed her anger around her chronic pain and lessened her anxiety toward future flares.

Over time, Emily began to notice a difference. She found that when she accepted her pain without letting fear take over, it didn’t control her life as much. Her stress levels decreased, and as a result, her pain became more manageable and even decreased!

Chronic pain can feel isolating. Remember to find support in friends and family, or reach out for professional help.

Breaking the Stress-Pain Cycle

The good news is that understanding the connection between stress and pain gives you the power to intervene. Here are some practical steps to break the cycle:

1. Regulate Your Nervous System

Engaging in activities that calm your nervous system can reduce the intensity of pain. Techniques like diaphragmatic breathing, progressive muscle relaxation, and grounding exercises can help shift your body out of fight-or-flight mode and into a state of rest and repair. Also, studies show that mindfulness practices, such as meditation or mindful movement (like yoga), can reduce both stress and physical pain by helping your brain reframe how it interprets pain signals.

2. Seek Professional Support

Working with a therapist around the mind-body connection can help you develop personalized strategies to manage stress and pain. Together, you can explore techniques like somatic therapy, attachment work, or polyvagal exercises to calm your nervous system and reduce discomfort. EMDR (Eye Movement Desensitization and Reprocessing) can help process emotions that may contribute to chronic pain and help desensitize your reaction to pain. Processing and reducing these emotional reactions can lead to a more balanced emotional state, which can, in turn, ease the perception of pain.

3. Build a Support System

Chronic pain and stress can feel isolating. Reaching out to friends, family, or support groups can provide emotional relief and remind you that you’re not alone.

Moving Forward

Stress and physical pain may feel like an endless cycle, but it doesn’t have to be. By understanding how your mind and body are connected, you can take steps to manage stress, calm your nervous system, and find relief from pain. Remember, your pain is valid, and help is available. You don’t have to navigate this alone.

Disclaimer: The content provided on this blog is for informational and educational purposes only and is not a substitute for professional mental health advice, diagnosis, or treatment. While I aim to provide helpful and accurate insights, this blog does not establish a therapeutic relationship or constitute personalized advice. Always consult with a licensed therapist or healthcare provider regarding your unique situation before implementing any suggestions shared in this blog.