Stress. We all feel it. It is a constant part of our lives. If you are also living with chronic pain, then you manage the normal everyday stressors plus the stress that your body experiences from consistent pain signals. Understanding the bodily functions that regulate, respond to, and perpetuate stress is important to begin developing strategies to combat the viscous cycle that may be occurring between your pain and your stress.

Let’s talk about the autonomic nervous system—the system that runs your body’s autopilot functions, like breathing, digestion, and heart rate. It has two divisions: the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). These two are always in a tug-of-war, and that balance (or imbalance) can be the difference between thriving and surviving.

The Autonomic Nervous System: A Brief Overview

‍

The autonomic nervous system is the system that runs your body’s autopilot functions, like breathing, digestion, and heart rate. It operates without conscious effort and has two primary components:

1. Sympathetic Nervous System (SNS): The "fight, flight, or freeze" system activates during stress or perceived danger. When triggered, it floods the body with adrenaline, increasing heart rate, tensing muscles, and slowing digestion to prepare for immediate action. This response, while lifesaving in prehistoric times when bears and wolves might eat us alive without swift action, can be harmful when chronically activated despite a lack of immediate threat that we need to face.
2. ‍

‍

2. Parasympathetic Nervous System (PNS): The "rest and digest" system counterbalances the SNS. It slows heart rate, lowers blood pressure, and promotes healing and relaxation. Increased parasympathetic tone can significantly reduce stress and alleviate chronic pain. People with chronic pain tend to struggle to activate the PNS and spend more time living in “fight or flight,” even if they don’t consciously realize it.

‍

Chronic Stress and Its Impact on Health

‍

Modern life is rife with stressors, from work pressures to constant news updates to living with chronic pain. Unlike fleeting dangers faced by early humans, today’s stressors are often prolonged, keeping the sympathetic nervous system activated. This chronic activation can wreak havoc on the body:

• Physical Health Issues: Sustained stress increases the risk of hypertension, heart disease, stroke, and diabetes. Chronic muscle tension exacerbates pain conditions such as migraines and back pain.
• Brain Health Challenges: Stress diminishes the function of the prefrontal cortex, impairing decision-making and emotional regulation. Chronic exposure to cortisol, the stress hormone, damages neurons in the hippocampus, leading to memory issues and heightened emotional reactivity.

For individuals with chronic pain, stress can reinforce pain pathways in the brain, which then causes more stress – forming a difficult-to-break cycle. For people with chronic pain, it is even more critical to manage the stress response effectively.

‍

The Key to Balance: Activating the Parasympathetic Nervous System

‍

While the autonomic nervous system acts independently, certain behaviors can influence its balance, shifting dominance from the stress-inducing SNS to the restorative PNS.

‍

Factors That Heighten Stress (Sympathetic Tone)

‍

Some common habits contribute to chronic stress activation:

• Shallow chest breathing (Note: people with chronic pain frequently do this unknowingly!)
• Consuming caffeine, nicotine, alcohol, or excess sugar
• Opioid use
• Toxic or stressful environments (e.g., abusive spouse, difficult boss, violent neighborhood)
• Listening to doomsday news too often  

You don’t have to eliminate your favorite indulgences entirely, but awareness of their impact can help you make mindful adjustments and counteract them with more calming choices to activate parasympathetic tone.

‍

Practices to Boost Relaxation (Parasympathetic Tone)

‍

Integrating PNS-activating habits into your daily routine can lower stress and improve your body’s ability to heal.

1. Get Moving: Physical activity, from intense cardio to light gardening, helps manage stress and promote better sleep. Practices like yoga and tai chi relieve muscle tension while calming the mind.
2. Prioritize Sleep: Restorative sleep is essential for the body’s repair processes and emotional resilience.
3. Find Balance: Incorporate leisure activities that bring joy and relaxation.
4. Laugh Often: Laughter triggers the release of endorphins, the body’s natural painkillers.
5. Practice Deep Breathing: Diaphragmatic breathing signals the body to relax, improving brain chemistry and reducing tension.
6. Embrace Relaxation Techniques: Guided imagery, meditation, and progressive muscle relaxation create calm and reduce stress levels.
7. Use Aromatherapy: Calming scents like lavender or chamomile can soothe the nervous system.

‍

‍

Stress, Pain, and the Power of Neuroplasticity

‍

Chronic pain is deeply intertwined with the stress response. When stress overwhelms the brain, it defaults to familiar pathways, including those associated with pain. The good news? The brain’s neuroplasticity—the ability to form new neural connections and change itself—offers a way out. By consistently engaging in stress-reducing practices, you can retrain the brain to manage pain more effectively.

When a pain flare-up occurs, it can serve as a signal that something in the system is out of balance. Ask yourself, “What do I need right now to feel more regulated?” Whether it’s prioritizing sleep, reducing caffeine, or simply pausing for deep breaths, small, intentional actions can recalibrate the nervous system.

‍

Final Thought

‍

Understanding the interplay between the sympathetic and parasympathetic nervous systems unlocks the ability to manage stress and its effects on the brain and body. By cultivating habits that enhance parasympathetic tone, we not only reduce stress but also improve our capacity to handle pain and thrive.