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Panic and Chronic Pain

 

Worry about the Corona virus could be increasing your pain

I often network with my fellow therapists. Of course, we do not discuss our individual clients, client confidentiality comes first, but we do talk generally about what is going on. Everyone is saying the same thing at the moment. Worries about Corona virus, or COVID-19 are affecting nearly all their clients. Whatever people are coming to a therapist with: depression; anxiety; post-traumatic stress; or more general lifestyle issues, the virus is in their thoughts. 

Of course, none of us should be surprised about this. It is on the news 24 hours a day and in all the newspapers. It is undoubtedly a big issue and we need to make sure that we do the right thing and follow proper health advice.

But we also need to keep a balance. This is especially important for people who are predisposed to anxiety. If this is you, I hope you can use some self-help techniques to control your anxiety. (If you look further down this article you will find some suggestions). If these do not work, then please see a therapist, or even book a telephone or online consultation to get to the underlying causes of your anxiety. Remember there is a difference between concern over a dangerous and worrying situation and uncontrollable feelings of worry and even panic.

Pain and the Corona virus

For the rest of this blog post I want to concentrate on my area of specialty, that is helping people overcome chronic pain. It probably won’t surprise you to learn that if you are very worried your pain may feel worse.

I often find it helps my clients if I explain why this happens. There are some solid physical reasons for it, and here they are:

  1. Stress and anxiety trigger our hormones and release more adrenaline and cortisol in our systems. This can lead to us feeling hyped-up and even more stressed. 
  2. We know that stress can make pain worse. Acute stress (that is when you are in real and direct danger) can mask pain, (there are good reasons for this it enables us to deal with real and direct threats). Chronic stress, on the other hand, or feeling anxious all the time can cause a condition called hyperplasia which will raise your perception of pain. 
  3. Stress and anxiety will cause your muscles to tighten and this can itself increase pain. As your muscles become even tighter the pain will feel worse and you will tighten up even more. This is a nasty spiral and can feel awful.
  4. As your pain feels worse you will find it harder to concentrate on anything else. And focusing on pain makes it seem even more painful. Again, you are in a spiral.
  5. If you are very worried you will be altering your nervous system as well and this can increase your pain. This is because the very sensitive neurons which pass messages to our brains can become over-sensitive if you are under constant stress. This means they can over-report what is going on in your body, a slight twinge can feel like a major pain and of course that will concentrate your mind on that pain and you will tense and become even more anxious. Then the pain will feel even worse. You will be in a nasty vicious circle. There is some old-fashioned wisdom here. Do you remember a wise older relative telling you had overactive nerves? Well it turns out they were right! 

Pain and anxiety go together

There is a lot of evidence which proves this. One study, back in 2008, showed that people who suffered from muscle pain, headache or stomach pain were up to 10 times more likely to suffer from generalised anxiety than the general population. https://onlinelibrary.wiley.com/doi/abs/10.1002/da.20342 

So, we know all this as a general truth. And now we are faced with a world health crisis which can make this general anxiety worse. There is another nasty twist as well. It seems that the early symptoms of the virus are similar to some of the symptoms of anxiety conditions. For example, shortness of breath and a dry cough are very common in anxiety.

Breaking the cycle of anxiety and pain

I always advice my clients to practice anxiety management regularly. It can do us all good. If you are finding things tough with the news at the moment then you will certainly benefit from some good self-help routines.

There is solid science behind what I advise. We now understand much more about how our nervous system functions. If you envisage it as a loop, with the anxiety affecting all your major organs and thereby increasing pain and this then feeding back and further increasing anxiety which in turn further increases pain, you would not be far wrong. 

You can break the loop. 

You can find much more information on this site. http://www.apaininthemind.co.uk/resources/

Some techniques to break the anxiety loop

Here are a few techniques to get you started. 

Breathing

Count your breathing, in for four and out for six. Make sure you push your tummy out as you breathe, that means you are breathing deeply. Keep going until you feel your system slowing down and relaxing.

Progressive muscle relaxation 

Start at your feet and tense and relax all your major muscles on after the other. Work through all the groups right up to your neck (but avoid any which are causing you direct pain). Then, starting at your neck, go down again to your feet. 

Positive visualisation

Close your eyes and create or remember somewhere you love and where you feel at peace. Spend some time there and enjoy yourself. Make all the experiences you feel as strong as possible by using all your senses. 

Do these things if you are feeling anxious and you will notice a benefit. I would also advice you make them part of a daily routine. This will give your body a rest from anxiety and will help you control your pain.

Tips to cope in the crisis

Finally, I would like to suggest some particular things to do while we are facing this health emergency: 

  1. Don’t watch the news all the time. Keep up with the world but do it in short bursts. Do not have 24-hour news on all the time. Turn off the hourly bulletins on the radio. Constant news will just stress you and you won’t miss anything important by taking time off.
  2. Be careful who you take notice of. Listen to expert health information from the medical and nursing colleges and from the Department of Health and the World Health Organization. Do not listen to unknown people whose only qualification is a Twitter account. There is no reason to suppose they know what they are talking about and they can just end up scaring and confusing everyone else.
  3. Be prepared but do not obsess. Life does go on and many ordinary activities can continue as normal. Make sure you take plenty of time to do the things you like. 

I hope this is of help to you. Have a good month and I will see you soon.

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