Stress Management

Stress-Pain Connection

Stress directly affects pain through muscle tension, inflammation, and nervous system activation. Chronic stress keeps the body in "fight or flight" mode, amplifying pain signals and reducing the body's ability to cope.¹

How Stress Worsens Pain

• Increases muscle tension
• Raises cortisol and inflammation
• Sensitizes nervous system
• Disrupts sleep
• Reduces pain tolerance
• Leads to unhealthy coping

Relaxation Techniques²

• Deep breathing exercises
• Progressive muscle relaxation
• Guided imagery
• Meditation
• Body scan

Lifestyle Approaches

• Exercise - Natural stress reliever
• Social connection - Support reduces stress
• Time in nature - Proven stress reducer
• Hobbies - Enjoyable activities
• Limiting news/social media - Reduce triggers

Cognitive Approaches³

• Identify stress triggers
• Challenge unhelpful thoughts
• Problem-solving skills
• Acceptance of what can't be changed
• Focus on what you can control

Time Management

• Prioritize important tasks
• Learn to say no
• Break large tasks into smaller ones
• Build in buffer time
• Delegate when possible

When to Seek Help

• Stress feels overwhelming
• Affecting relationships or work
• Physical symptoms (headaches, GI issues)
• Using unhealthy coping methods

References

1. Hannibal KE, Bishop MD. Chronic stress, cortisol dysfunction, and pain: a psychoneuroendocrine rationale for stress management in pain rehabilitation. Phys Ther. 2014;94(12):1816-1825.
2. Morone NE, Greco CM. Mind-body interventions for chronic pain in older adults. Pain Med. 2007;8(4):359-375.
3. Turner JA, Anderson ML, Balderson BH, et al. Mindfulness-based stress reduction and cognitive behavioral therapy for chronic low back pain. Pain. 2016;157(11):2434-2444.