Does pain get worse when you are distressed?

How stress shows up as pain

Valentyna and Dana can see their pain getting worse after stress, while Ivan first needs to understand what has already been checked. But even a clear pattern does not replace an examination – the section “What explains this kind of pain” covers this.

What explains this kind of pain

Physical, psychological and social circumstances can influence pain together. Dividing pain into “real” and “psychological” is unhelpful. Clarify what has been checked, which changes need further assessment and how symptoms can be relieved.

If low mood and a fading interest in life have been there for a long time alongside the pain, a doctor will also consider possible depression. But the pain itself does not yet mean that you have depression.

Is there a pattern between pain and tension?

The term psychosomatic pain is often used for physical pain whose severity or course may be influenced not only by the condition of tissues and organs, but also by stress, emotional wellbeing, sleep, nervous system function and other factors. Try describing your pain with these questions:

• When did the pain first appear, and what was happening at that time?
• Is there an established illness, injury or other medical reason?
• Where do you feel the pain, and does its location change?
• What is it like: aching, burning, pressing, shooting or something else?
• Is the pain constant, or does it come in episodes?
• What makes the symptoms worse, and what eases them?

If you can see a link with stress, mention it to the doctor along with your other answers. If you cannot, that is a useful answer too: it does not make the pain any less important.

The boundaries of psychosomatic pain

The main sign of this pain is its link with stress. Other pages look at complaints where something else comes first:

• Body pain. Your back, joints or muscles hurt, and there is no visible link with stress.
• Muscle tension. Tightness in the shoulders, neck or jaw bothers you more than the pain itself.
• Headache. The pain is centred in the head.

There is no clear line between these complaints, and a doctor can help you sort them out.

Addressing physical and emotional needs together

The first step is a medical assessment and identification of possible mechanisms and causes of pain. The presence of emotional stress should not automatically stop the search for physical causes.

For chronic pain, treatment often requires a combined approach. Depending on the condition, it may include medication, physical rehabilitation, a gradual return to activity, work on sleep and psychotherapy.

Psychotherapy for chronic pain is not aimed at proving that the pain is “psychological”. It may help reduce fear of pain, catastrophising, avoidance of activity, chronic tension and the impact of symptoms on life. It works not only with the question “Why do I have pain?”, but also with “How has pain changed my life, and what will help me gradually regain more activity, independence and quality of life?”

Your first visit: a family doctor

A family doctor will examine you, ask where and how it hurts, what has already been checked and what changes the pain, and decide whether you need tests or another specialist.

If you would also like to discuss the pain and your mood with a mental health professional, read the initial psychiatric consultation page beforehand, so the first meeting does not come as a surprise. Choosing whom to book with is easy from the list of the clinic’s doctors.

Where to turn with pain

1. If the pain comes on suddenly and is of unusual intensity, or comes with chest pain or pressure, severe shortness of breath, loss of consciousness, sudden weakness or numbness, difficulty speaking, high fever, serious injury or a rapid deterioration in your general condition, you need urgent medical help: call 103 or 112 in Ukraine.
2. If the pain persists, recurs, gets worse or significantly limits your daily activities, see a doctor.
3. If tests have not explained why the pain is so strong or lasts so long, ask your doctor about a comprehensive assessment of chronic pain.
4. If long-lasting pain comes with severe anxiety, low mood, sleep problems, social isolation or constant fear for your health, it may help to see a mental health professional with experience of chronic pain and physical symptoms as well.
5. If the pain has already been checked and you notice that it gets worse on tense days, ask your doctor whether the approaches in the section “Addressing physical and emotional needs together” would suit you.