I think It’s safe to say that it’s common knowledge that stress disrupts life in many ways. It can effect sleep, thoughts, feelings, behaviour and even increase the risk of certain health issues. But what about when you have musculoskeletal symptoms, such as lower back pain, headaches or neck pain how do you think stress effects these issues and more importantly have you ever given a thought as to how stress can impact your healing process when you have an injury whether that be an inflamed joint, an unhappy disc, an ankle sprain?
The healing process is a complex one and I am sure we have all taken it for granted when we see a blister or a paper cut heal in a matter of days. But when you delve into what has happened for this healing to occur you realise there was a complicated range of vascular changes, cellular changes and neural changes. Have you ever had a wound in the past that has taken a slower amount of time to heal? What was your mental health like? Was there an increase in your general stress levels?
There is an array of literature out there that shows increased stress levels can lead to a significant decrease in tissue healing. Alford (2007) suggests that stress can delay healing up to 60%. What has been suggested is that there is a reduced amount of pro inflammatory cytokines at the site of injury of individuals who are stressed. These pro inflammatory cytokines play a major role in tissue repair by clearing the wound as well as bringing in cells that promote healing and repair.
March et al (1998) found that there was 40% slower healing time to students who were trying to heal a hard palate wound during exam block compared to another hard palate wound during the holiday break. It really makes you think that even every day stressors can have a major impact to healing. Jennings et al explain that exposure to acute or chronic stress can even increase pain levels in a clinical environment.
As a physiotherapist there are many approaches to help create an environment conducive to healing, from graded movement, education, hands on therapy but if stress alone can delay healing time and even exacerbate pain symptoms perhaps what we must not forget is finding ways of decreasing the stress response.
Things that put me into a parasympathetic mode (i.e. the part of the nervous system associated with rest and digest) and help decrease stress include: Diaphragmatic breathing exercises, writing a list of things that I am grateful for, Zen Thai Shiatsu treatments, any sort of moving including walking, jogging, yoga, stretching, strength training,Daily self care that includes a handful of things I do every morning that helps me start my day in the best way possible.
What would be your way of decreasing stress in your life?
Alford, L. (2007). Findings of interest from immunology and psychoneuroimamunology. Manual Therapy, 12(2), 176–180. doi:10.1016/j.math.2006.06.007
Marucha, P. T., Kiecolt-Glaser, J. K., & Favagehi, M. (1998). Mucosal Wound Healing Is Impaired by Examination Stress. Psychosomatic Medicine, 60(3), 362–365. doi:10.1097/00006842-199805000-00025
Jennings, E. M., Okine, B. N., Roche, M., & Finn, D. P. (2014). Stress-induced hyperalgesia. Progress in Neurobiology, 121, 1–18. doi:10.1016/j.pneurobio.2014.06.003