Stress, Sleep, and Chronic Pain

There is nothing I hate more than being told to “destress” when discussing my chronic illness with healthcare providers. It sounds inherently dismissive, and if all of my issues could be fixed by doing yoga and taking bubble baths every day don’t you think I would have tried that by now?! Stress can be a component of chronic illness and pain, but it is not the singular cause or solution to most health conditions. 

As a chiropractor, I have found that many patients say that stress does worsen their chronic pain symptoms. It turns out there is a scientific explanation for this! Stress increases a neurotransmitter in the body known as Substance P. Substance P is responsible for transmitting pain signals and producing the inflammatory response. In the simplest of terms, more Substance P results in more pain and inflammation. Therefore, an increase in stress can directly impact pain and inflammation.

Stress also plays a role in our “happy” emotions by decreasing serotonin. Many of us have heard of serotonin because of the growing popularity of SSRI antidepressants (Selective Serotonin Reuptake Inhibitors). Serotonin is the “feel-good” neurotransmitter- which is why SSRI’s aim to increase your levels of serotonin. HIgher levels of stress can make it harder to feel positive emotions because of the decrease in serotonin.

You may also have heard of melatonin supplements that people take before bed. Melatonin is responsible for your sleep wake cycle, and is actually produced within the body from serotonin. If you have noticed that stress also impacts your sleep, this is why. Stress has decreased the amount of serotonin in your body, reducing the amount that is available to be converted into melatonin. This can be a vicious cycle because proper sleep is often needed to get out of a period of high stress, but the stress itself can inhibit sleep. This can further the chronic pain response because sleep can also play a crucial role in the body’s healing processes.

This was a lot of scientific jargon, but the take-away here is that stress increases pain and inflammation, decreases “feel-good” emotions, and makes it harder to sleep. Knowing all of this can help us understand the importance of stress management, but please keep in mind that this is just one explanation as to how stress impacts chronic conditions. I will never be a healthcare provider that dismisses pain by saying it is “just stress,” but I may use stress management techniques as part of your care plan!