Chronic Pain can change the way we interpret pain. It can make us more sensitive to non-painful stimuli and can exaggerate the pain we feel. During periods of pain/stress the brain repeatedly releases hormones into the body and produces cortisol. Cortisol is a hormone to help the body use sugar and fat for energy, and it is released in our flight or fight (stress) response. If this pain/stress trigger lingers for a long period of time, excess cortisol accumulates into the body. To compensate for this high cortisol level, our body stops releasing hormones that produce cortisol to maintain normal levels. High cortisol levels are are thought to be dangerous and contribute to long-term health problems.
In chronic pain individuals, their blood cortisol levels are lower than normal. That’s good right? WRONG! Our body’s cortisol response is based on a negative feedback loop. For example, too much of a hormone in the body will be turned off so it brings the high levels back to normal. But in chronic pain individuals, their body’s system will continue to producing cortisol, lengthening and enhancing the stress response. As a result, this stress system is unable to be turned off and will run for a longer period of time when compared to a individual with no pain. These effects are seen in patients with depression and anxiety disorders as well.
Remarkably, the brain is able to make memories and associations based on this stress response. Which means, if you experienced pain picking up a pencil from the floor, the brain will associate that action in the future as painful. Ultimately, triggering the stress response and leading to this endless cascade. In addition, the brain will learn to perceive more and more actions as painful. As a result it will exaggerate our fears and sensitize your reactions, leading to this fear-avoidance that anything you do may be painful.
Ways to help you control your cortisol levels in the body include: