The Missing Link in Pain Rehabilitation: Understanding the Stress Response

When recovering from pain — whether through chiropractic care, physiotherapy, or other rehabilitation methods — there’s a key factor often overlooked: stress.

Most treatment protocols focus on the physical mechanics of injury or pain. But pain doesn’t happen in isolation. It’s closely linked to the nervous system, and stress plays a powerful role in how pain develops, lingers, and eventually either fades — or becomes chronic.

Let’s explore how your body responds to stress, how that response influences pain, and why addressing stress may be the missing piece in your recovery journey.

Stress and the Fight-or-Flight Response

When your brain perceives a threat — whether it’s physical, emotional, or environmental — your body reacts by activating the fight-or-flight response. This is a built-in survival mechanism that dates back to our earliest ancestors. Its purpose is to get you out of danger fast.

The body releases three key stress hormones:

• Epinephrine (adrenaline)

• Norepinephrine

• Cortisol

Cortisol, in particular, is not just a stress hormone. It also acts as an anti-inflammatory and helps release stored glucose for energy. In the short term, this response allows the body to respond to pain or threat and avoid tissue damage.

But what happens when the stress doesn’t stop?

Chronic Stress and Cortisol Dysfunction

Stress from a near car crash or an intense argument might only last minutes. But many people today face prolonged stressors like:

• Financial problems

• High workloads

• Relationship conflict

• Poor sleep

• Constant digital overload

When stress becomes chronic, cortisol stays elevated — or eventually drops too low. This creates cortisol dysfunction, leading to:

• Increased pain sensitivity

• Persistent inflammation

• A weakened immune response

• Slower tissue repair

This is how long-term stress becomes a chronic pain amplifier, even when the original injury has healed.

The Nervous System’s Role in Pain and Stress

Your autonomic nervous system controls unconscious functions — like your heart rate, digestion, and breathing — and it’s divided into two branches:

1. Sympathetic Nervous System (Fight or Flight)

Activates in response to stress, causing:

• Increased heart rate and blood pressure

• Faster breathing

• Pupils dilating

• Sweating

• Decreased digestion ("butterflies in the stomach")

• Increased blood sugar from the liver

• Pain suppression through natural endorphins

This system prepares you to run or fight, redirecting energy away from digestion and healing.

2. Parasympathetic Nervous System (Rest and Digest)

Brings the body back into balance after stress:

• Slows heart rate

• Promotes digestion

• Supports tissue repair

• Lowers inflammation

Chronic stress keeps the sympathetic system dominant, which blocks your body's ability to rest, recover, and heal from pain.

How Pain Is Processed in the Body

Pain is more than a symptom — it’s a message. When tissues are damaged (from injury, inflammation, or even long-standing tension), nerve endings send pain signals through the spinal cord to the brain.

Here’s the pathway:

• Nerve sensory cells detect tissue damage

• Signals travel to the spinal cord

• They’re relayed to the thalamus (the brain’s sorting station)

• Finally, the cortex interprets the signal as pain

There are Two Main Types of Pain:

• Acute pain – Sharp, immediate, protective (like a burn or cut). It triggers a fast reaction to prevent further damage.

• Chronic pain – Dull, aching, throbbing. This lingers long after tissue healing and is often linked to nervous system dysregulation and chronic stress.

Chronic pain can even begin without a clear injury, particularly when the nervous system remains in a hyper-alert state due to prolonged stress.

The Physical Signs of Fear and Stress

Here’s how your body physically responds to fear or high stress:

• Energy surge – Glucose is released for quick energy

• Rapid breathing – More oxygen to the brain and muscles

• Increased strength – More blood to muscles

• Pale skin – Blood moves away from the surface to reduce bleeding risk

• Pounding heart – Faster circulation of oxygen and nutrients

• Pain resistance – The brain releases endorphins to mask pain

• Sweating – Regulates body temperature

• Butterflies in the stomach – Blood is diverted from digestion

• Dilated pupils – Improved vision for detecting threats

While all of these responses are normal in short bursts, when they happen continuously, they deplete the body, causing muscle tension, fatigue, and poor healing.

What Does This Mean for Pain Rehab?

If you're recovering from pain — especially chronic pain — and stress isn’t being addressed, you're missing a major part of the puzzle.

Muscle work, adjustments, or exercises are important. But if your body is stuck in fight-or-flight mode, healing slows down, pain feels worse, and inflammation lingers.

Supporting the parasympathetic nervous system (rest and digest) through breathwork, gentle movement, nutrition, sleep, and emotional support can accelerate recovery and reduce chronic pain.

Pain is a signal — not just of injury, but of imbalance. And stress is often the invisible layer that keeps pain alive, long after the original injury is gone.

If you’re struggling with pain that won’t resolve, don’t just look at the muscles and joints. Look at your nervous system, your stress load, and your body’s ability to return to calm.

That’s where deep healing begins.

Want help exploring the stress-pain connection in your life or practice? Reach out — I’d love to help you support your body from the inside out.

Subscribe to my FREE newsletter.

Start a FULLSCRIPT account to get personalized supplements that will work for you specifically. I will personally assist you and you get discounts every time!

Get a free consult via email, phone or in-person to see how I can help you!
— Janette de Vries, RHN, B.Ed, H.BA

YouNique Holistic Nutrition