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Does Stress Increase Pain Itself or the Perception of Pain?

In the stress-filled society of today, more and more people suffer from the effects of this chronic stress on their bodies. The incidence of autoimmune conditions continues to increase, more people consult their healthcare professionals for help dealing with stress. Almost 10 years ago, the estimated annual cost of the impact of chronic pain was over $600 billion and has continued to rise ever since. But does stress increase pain? Research suggests that it does. And whether stress increases pain directly, or your perception of pain, you hurt more when you experience stress. Here's how to break the cycle.

Does Stress Increase Pain? The Cycle of Pain and Stress

An image of a woman holding her neck and back in painYou know chronic pain can become a source of stress. Hurting continuously inherently stresses a person. It interferes with every aspect of your daily life. You can’t concentrate on work effectively, you can’t care for your family the way you want, and you don’t enjoy things you enjoyed before hurting.

But does stress increase pain? While the answer seems clear, researchers still search for the definitive answer to the question. More and more, they tend to believe it does.

The next question looms large. Does stress increase pain itself or your perception of pain? In other words, does stress cause you to feel your pain more?

The Role of Inflammation in Pain

One thing that appears very clear: Inflammation leads to increased pain. And one major source of inflammation involves stress.

Studies show that stress exacerbates pain and can lead to a ‘pain flare’. The mechanism behind these pain flares seems to lie in the stress response that increases inflammation.

When stress hits your body, regardless of the source of stress, the same response occurs. Your body becomes activated to deal with the stress. Ultimately, your adrenal glands release cortisol, a stress-fighting hormone. Over a period of continued stress, the adrenals can become overwhelmed by the demand for cortisol and thus not able to provide enough to meet the demand. This begins Adrenal Fatigue Syndrome (AFS). In addition, it triggers another natural mechanism, the NeuroEndoMetabolic (NEM) stress response. This mechanism works to keep your body balanced in the face of stress. However, with continuing chronic stress, its six circuits become dysregulated.

As a result, a cascade of symptoms appears that results in your immune system producing increased inflammation throughout your body. Consequently, this increased inflammation leads to increased pain.

One way an increase in inflammation brings on increased pain involves irritation to nerves in the area of increased inflammation. The nerves in those areas become more sensitive, requiring less stimulation to cause pain. Therefore, your perception of pain in those areas increases.

In addition, as stress continues and becomes more chronic, this sensitization of nerves becomes more widespread. Further, this widespread increase in sensitive nerves leads to general body aches and pains.

In this way, inflammation provides one answer to the question, “Does stress increase pain?” Stress increases inflammation, which irritates nerves, which both increases pain and your perception of pain.

Stress and the Perception of Pain

One issue that must receive attention when discussing whether stress increases pain, should be your perception of pain. In other words, do you feel pain more when under stress?

Research indicates that a combination of fear, stress, and anxiety amplifies the duration of pain and its intensity. This is not surprising because of the relationship between stress and inflammation mentioned earlier.

In addition, there is another factor that plays an important role in how you perceive pain. People who suffer from AFS often experience a low ability to tolerate pain from any source. And it is also found through research that a negative mood that often accompanies chronic stress, in turn, increases pain and reduces social interaction.

Studies have also shown that the level of the stress-fighting hormone cortisol is high in people with chronic pain. This indicates that the pain acts as a source of stress, triggering the same physical response as any other stressor. Further, it appears logical to assume the same response would result from any source of pain.

Reduced Dopamine and Pain

Chronic stress and AFS decrease your body’s ability to control pain sensations.

Normally, your body uses the hormone dopamine to help deal with pain. But the production of dopamine depends on the production of pregnenolone. Research shows pregnenolone sulfate stimulates the release of dopamine. However, in cases of chronic stress, your body needs increased amounts of pregnenolone in order to produce sufficient cortisol to fight the effects of stress.

Therefore, this leads to reduced amounts of pregnenolone for the production of other hormones, such as dopamine. As a result, the lower levels of dopamine lead to lower pain tolerance for those who suffer from AFS.

Neck and Back Pain

An image of a man holding his neck in painOne area that could be especially helpful in answering the question of "does stress increase pain" is neck and back pain. Research shows repeated bouts of stress can cause musculoskeletal changes that cause neck and back pain.

Adrenaline, one of the hormones released when you experience stress, increases blood pressure, supplying more blood to the muscles, and causes muscles along the spine to tense in case you need to flee from a stressor.

In addition, cortisol, another hormone released by stress, can lead to loss of muscle mass. This loss can then stimulate pain.

An online survey conducted by found the number one cause of neck and back pain among adults to be stress.

Stress-induced tension in the neck can lead to headaches and muscle pain. With chronic stress, this tension also brings on irritability, depression, and increased fatigue.

Back pain often becomes differentiated into mid-back and lower-back pain. Mid-back pain can result from changes in breathing patterns brought on by stress. These changes bring on strain and tension in the mid-back, resulting in pain.

Lower-back pain involves muscles that affect posture and flexibility. With increasing stress, people often become more sedentary, exercising and stretching less. This causes muscles in the lower back to become stiff and painful.

So, research and clinical experience do help answer the question, “Does stress increase pain?”

Reducing Stress-Induced Pain

Many people choose to consult their healthcare professionals and get prescribed medications to deal with pain. However, this may not work for several reasons. Firstly, the chances of becoming habituated to low doses of prescribed pain medications can lead to increased dosages and potential addiction.

Secondly, the side effects of prescription medications may prove intolerable for many.

Thirdly, people with AFS may respond atypically to these kinds of medications. Paradoxical reactions may result in worsening pain responses.

These potential downfalls of prescription medications for pain relief make natural approaches more attractive. While these kinds of interventions may take longer to resolve pain, they do not bring on the negative effects so often seen with prescription medications, and they come with long-term health benefits.


Exercising and stretching can help you deal with your pain, especially pain centered in your back and neck. Of course, if you have other health issues like adrenal fatigue, it's a good idea to consult your healthcare professional before engaging in increased exercise to avoid anything that could harm you. Yoga is an excellent choice for exercise.


Changing your diet can lead to increased energy that so often becomes lowered when under stress. Eating well long-term will improve your general health, can help you lose weight, and can help you have more energy to exercise and stretch.


Getting good quality sleep can help you deal with the stress that often exacerbates both your pain and your perception of pain. Sleeplessness is a stressor in itself and can even worsen hormone imbalances and cause weight gain. You may need to modify your sleeping conditions in order to get around the sleeplessness brought on by pain.

Herbal Pain Relievers

Turmeric and ginger can help lessen pain because they help alleviate inflammation.

Bright red and purple fruits and vegetables contain antioxidants to fight free radicals.

Cloves can be used internally or externally to alleviate some types of pain. However, you should consult your healthcare provider before using cloves if you suffer from a bleeding disorder or take blood thinners.

However, if you have AFS or sensitivities, always talk to a doctor aware of AFS before adding new foods to your diet because of the higher risk of paradoxical reactions.

Meditation and Biofeedback

Learning how to focus on your breathing, clear your mind, and stop focusing on your pain can make a huge difference in your perception of it. Both mindfulness meditation, yoga breathing techniques, and biofeedback training provide ways to do this.


Research and clinical experience show stress increases both physical pain and the perception of pain. The production of inflammation due to stress increases nerve sensitivity to inflammation. If you already experience pain at the site of inflammation, your perception of that pain increases. If you didn’t have pain prior to inflammation in an area, the heightened sensitivity of the nerves there can result in pain and body aches. In addition, changes in hormones due to stress can lead to changes in muscle activity which can lead to pain. And people suffering from AFS can cease physical activity which then increases pain and pain perception.

What Can You Do?

If you are suffering from pain caused by stress, here are a few things you can do to alleviate the situation:

    An image of a man meditating

  • Do all you can to reduce your overall stress levels, including trying meditation.
  • Exercise carefully and only at moderate levels - yoga is a good option.
  • Improve your diet to increase energy.

Whatever course of action you decide to take, however, please do so with the guidance of your healthcare professional who can help you look at options and choose the best one for you.

If you would like to know more about the question, “Does stress increase pain?”, the team at Dr. Lam Coaching can help. We offer a free** no-obligation phone consultation at +1-626-571-1234 where we will privately discuss your symptoms and various options. You can also send us a question through our Ask The Doctor system by clicking here.

© Copyright 2021 Michael Lam, M.D. All Rights Reserved.

Dr. Lam’s Key Question

A different way of looking at this question has to do with how does stress increase pain. Pain and stress revolve around each other in a reciprocal process. Inflammation from stress makes nerve endings more sensitive, thereby increasing pain. Pain itself becomes a stressor, thereby generating more stress.

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