It is rare that durning rehabilitation for pain (chiropractor or pysiotherapist) that stress is addressed. Fear, threat to personal safety or well-being are psyiological responses to stress that evoke epinephrine, norepinephrine and cortisol secretion to encourage survival. This is known as the 'fight-or-flight response'. Cortisol is an anti-inflammatory that signals the stored glucose to be released for energy and to keep inflammation under control in order to prevent nerve and tissue damage. Short term stress can adapt to pain and non-pain (nonmuscleskelatal like visceral pain) stressors to increase cortisol secretion. Long term stress can create a cortisol dysfunction, pain and inflammation.
The body responds to stress through the autonomic nervous system to signal organs to provide adjustments to keep the body operating in homeostasis. The sympathetic nervous system will alter sweating, reflexes and increased heart rate as this whole system is activated during 'fight or flight' response. This part of the nervous system stimulates simultaneously control over all of these organs within the sympathetic system (brain, eyes, lungs heart, bladder, digestive system, liver, spinal cord, kidneys, adreanal glands). The other part of the autonomic nervous system is the parasympathetic that generally serves the same organs as the sympathetic system, but it has an opposite effect on the organs. For example, lowering heart rate and respiration, wheras the sympathetic system increases heart rate and breathing.
The body responds to fear by:
Energy surge - increase metabolism, liver produces glucose
Rapid breathing - enlarged airways to increase oxygen increase
Increase physical strength - increased blood flow to muscles
Pale skin - reduced blood flow to skin so superficial wounds blood loss is decreased
Pounding heart - rising blood pressure to allow heart to beat faster for more blood flow carrying oxygen and nutrients to limbs, brain and heart
Resistance to pain - secretion of pain killers (endorphins) from brain
Sweating - keep body cool
Butterflies - decreased blood flow to stomach and directed to vital organs
Puplis dilate - shapen vision
Prolonged (chronic) stress can be caused by things like finacial worries late for work, a person's reaction or heavy workload. This means there is no relaxation for the body from stress. The effects of prolonged stress are wasting tissue, headaches, high blood pressure (leads to heart, kidney and vessel damage), fatigue and abdominal pain.
Pain signals tissues being damaged and alerts us to this damage. Chemical changes within the tissue creates a response that are pain impulses sent out by the nerve sensory cells that are relayed to the spinal cord. Then the relay stations in the spinal cord continue to relay messages to the lower part of the brain, the thalamus and eventually it reaches the higher part of the brain. This is where the message is preceived as pain after being analysed. There are two types of pain that is indicated by the speed of the sensors. Acute pain is sharp and stabbing pain felt as soon as there is an indication of tissue damage. The speed is to bring out an immediate reaction to remove the body from danage being a burn, cut or stress (fear). Acute pain can be felt less over time and replaced with a dull, aching, throbbing and persisten feeling that is known as chronic pain. With pain, there is a reactions like swelling and redness.
Abrahams, Peter Dr. How the Body Works: A Comprehensive Illustrated Encyclopedia of Anatomy. London. Amber Books Ltd: 2007.