Module 3 - Stress response - He tauhohe ahotea

Here is a brief video about this module: Introduction to the Stress Response

Pain triggers changes in our body similar to other threats or excitements. The stress response and pain overview HE3213 examines the relationship between pain and the stress response.

Tip of the week

Breathe out

Take notice of your breathing pattern. Sigh or breathe out slowly when you notice your pain ramp up or before you start an activity that can increase your pain. Sing a song or waiata. Reducing stress in your body is another treasure tool in your kete. 

Using the tiger as an indicator of threat, can help you understand your pain, and consider the appraisal of what is happening in your body: Tiger in the room HE3211

As pain triggers the stress response it is important to be aware how stress impacts on a range of aspects of our body, this journal article describes and summarises these: Stress effects on the body

The physical effects of the stress response include muscle tension, focus and worry about the body and changes in breathing.  These responses in turn can wind up pain and as pain is a trigger for the stress response this can lead to a vicious cycle with pain winding up more and more: The stress response and pain HE3210

Here are all the systems and areas of the body affected by this system: 

• Headache
• Difficulty concentrating
• Dry mouth
• Chest pain
• Fast breathing
• Insomnia
• Heart pounding
• Cold, sweaty skin
• Tense muscles
• High blood pressure
• Stomachache
• Frequent urination

Notice the changes that occur in your body with pain and stress.

You may think of times when you are very stressed, here we will invite you to notice some that can occur early on. Becoming more aware of your physical experience of stress will then allow you to put things in place at an earlier stage: Fight-flight-freeze: The body's natural response to stress | Anxiety NZ

Pain impact the body and thoughts and feelings – which impact our behaviour.  Activity avoidance can often follow as one tries to limit pain: Naming the fear

Although the changes of the stress response happen automatically, we can interfere with these changes using breathing and other ways of relaxing the body.  Try these breathing exercises to manage the stress response:

• Breathing for pain
• Breathe out
• Counting and breathing

Appreciating that pain is a protective output from the brain, in response to threat, it is useful to examine the many factors that increase your sense of danger and safety.  Threat occurs when the credible evidence of danger to your body is greater than the credible evidence of safety and this can directly impact on your pain.  Being around a person that you feel confident and safe with will feel different in your body to being around someone you don’t trust or someone berating you.  Although there are some common themes to of threat to all humans, there are a wide range of individual variabilities.  Some are threatened by small spiders in the corner, others adore these creatures. Some enjoy getting a massage, others feel it invades their privacy.  A bunch of Australian clinicians at the Neuro Orthopaedic Institute (NOI), have developed a framework to help you apply this principle to explore the many factors that can influence your personal sense of safety and threat and how this might impact your pain. Your pain may fluctuate a lot and although some pain flares may occur at random, many will be influenced by factors that impact on your deeper sense of safety. They have labelled things that raise your sense of threat DIMS – Danger In Me. SIMS are factors that increase your sense of safety – Safety In Me. We invite you to look at the next document and fill in the blank squares with your personal SIMS and DIMS. The idea is to become aware of your sense of threat and to consider ways to increase your sense of safety when navigating tricky situations Protectometer

Listen to Bronwyn, Natalie and Cara used their understanding of the stress response to help manage their pain

In summary:

Pain activates the stress response and stress increases pain. These physiological changes can lead you to feel worse and do less. By noticing these changes in your body and your thoughts, re-appraising the threat that comes alongside pain in your body and the sense of danger that is around you, you can influence your pain. When you slow your breathing, you reduce the level of stress your body is under.