Triggers and Techniques to Manage Stress Induced Pain

To follow on from my first article last month looking at ways where you can incorporate stretches and exercises into your new ‘home-working day’ to alleviate neck, shoulder and back pains. This month I want to cover some current triggers for and strategies to manage stress induced physical pains that I am increasingly seeing in clinic.

As an osteopath in all the years I have been working I have never known it to be so busy in clinic. Some of the symptoms’ patients are coming in with are increasingly complex. For many people, particularly women, the last 6 months have brought up many suppressed emotions, past emotional trauma or past injuries that are now triggering old and new physical aches and pains. These have been showing up as neck and shoulder blade pain, headaches, chest, jaw and lower back pains.

Discussing this with osteopath colleagues across the country we are seeing similar presentations. At the moment stress and anxiety levels are as high as ever. People have had to use all their coping strategies to manage their new ‘work life at home’ lifestyles during lockdown and constantly shifting restrictions. However, after all this time people are now getting to a point where they cannot cope with continual pain and are reaching out for help.

I am particularly seeing many mums who are exhausted from months of juggling childcare, home schooling, home making, their relationships and work commitments on a daily basis. Even since nurseries and schools have reopened new demands on how we and our children are to behave, react and deal with the ever-changing situation is adding to the physical and mental juggling balls and to do lists!

In addition, parents who have school age children are now freer to do more exercise again are experiencing injuries from not pacing themselves as they return to exercise regimes.You may relate to these examples and I thought it might be helpful to look at why pain is experienced and what you can do to help yourself.

When someone is in pain, their bodies start to subconsciously adapt to try and alleviate it. Whether the pain is from a build-up of tension in muscles from stress, a lapse in maintaining a good posture or from overstraining weak muscles, the most natural way you adapt is to stop moving the parts that hurt.

Unintentionally you end up getting yourself into new awkward positions and changing your gait to avoid the pain – which in turn over time then causes aches and pains in other places. A vicious circle!

With pain you also stop breathing properly. You become more guarded with the way you move and without using your main breathing muscle – the diaphragm – you start to mouth breathe overusing secondary respiratory muscles in your neck. You start to clench your jaw without realising it adding to the list of pains!

All of these actions can contribute to producing more pain. So what can you do to help yourself when you’re in this ‘Catch 22’ situation.

A useful exercise that I often use to illustrate why it is key to keep moving your body even when you are in pain. It involves squeezing your fist very tightly. Keep squeezing and you see your knuckles go white and it will begin to ache. Did you notice you stopped breathing for a time too? Now when you open your fist and fingers you’ll find they feel stiff. The blood rushes into your hand and fingers and the skin colour returns to a healthy colour. When a muscle or soft tissue is held in a position it doesn’t want to be in i.e from an injury, posture related ache or tension from stress – the body releases chemicals as an inflammatory response. You’ll have read Maya’s brilliant articles on inflammation so you’ll know this is a natural process. But it is how you manage this process. If these chemicals do not drain away from the injured muscle/soft tissue area once they have finished their function of protecting and healing then they stay in the tissues. These chemicals irritate nerve endings in the area which cause more pain. So improving circulation to painful areas by applying cold packs in the first 48 hrs for up to a maximum of 10 minutes over regular intervals in the day will help. Then alternating cold and heat packs in the following days will continue to promote healing in the painful area.

However, breathing is also key as it works together with the heart, circulation, nervous system, hormone or endocrine system and metabolism to keep all our body cells healthy, promote healing and calming the body.

When good nutrition, oxygen and a balance of hormones come into the cells and tissues with efficient drainage of all the toxic or used chemicals, then tissues can function properly and heal.

I have included two short videos with this article. The first illustrates mouth breathing when the neck muscles are used. The second one demonstrates a simple diaphragm breathing technique to help with relaxing the body and therefore promoting healing.

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A demonstration of how mouth breathing can cause pain in the neck and shoulder muscles.

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Diaphragm breathing helping the body relax and alleviate stress and pain.

Lie on your back with your knees bent up with a pillow under them for support if this helps ease any pains. If you’re in too much pain and can only sit then find a supportive seat with a good lumbar support. Place your hands on your lower ribs / upper abdomen. Keeping your mouth closed, take a breath in through your nose focusing on feeling your ribs expand outwards on a count of 4. Your diaphragm is doming down as your lungs fill up. On the out breath (expiration) breathe out through your mouth for a count of 6 so you feel all the air has left your lungs. Repeat this 3 times really focussing your mind on the breath and movement of the rib cage. This can then be repeated many times during the day – perhaps if you are using the cold pack on the painful parts of your body you can do this exercise.

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There is no limit to the number of times or when you do these exercises during the day. I hope they help as so often people forget to breathe when they are in pain.

Another common area which people tense when they are in pain is the jaw. The jaw is very closely linked with the upper neck in relation to the bones and muscles that help its movement. The muscles in the front of the neck and under the chin can be surprisingly tender. If you open and close your mouth slowly you may find more tension in one side of the jaw than the other. This may reflect in giving you neck pain or stiffness on the same side.

Three very quick techniques to release the jaw can be done at any time and multiple times. Just opening your mouth fully slowly and then moving the lower jaw from side to side 5 times holding for 3 secs each way. Relax the jaw and then squeeze your eyes tightly shut for a few seconds and then release. To release the muscles under the chin which move the tongue sit at a table with your elbows resting on the table top. Place your thumbs gently under each side of the chin where you feel the soft tissue give. Whilst in this position gently lift your tongue to the top of your mouth. Hold for 5 seconds and release – repeat 3 times. Again there is no limit on the number of times you repeat these just don’t press too hard!

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I hope you can relate to the above triggers and find these techniques helpful.