Is Your Reaction to Pain Worse Than the Pain?
Don’t worry, you won’t see the term “catastrophizing” here.
Your reaction to pain is always appropriate for whatever your experience happens to be.
However, no matter what your natural emotional reaction is, there is another reaction happening on an unconscious level. This unconscious reaction is being orchestrated by your nervous system.
Your nervous system reaction, impacts your physical body.
It changes how you subconsciously hold yourself.
I’m talking about the “autonomic” part of the nervous system. Just like that sounds, it’s the part of the nervous system that creates automatic responses. Like any experience, the way in which your autonomic nervous system (ANS) reacts, can be informed by past experiences.
This ANS part of our biology, comes with built-in or “native” programming designed to help us survive. It’s protective. And in the right situations, it can be very helpful.
The ANS allows us to take action without wasting precious minutes -thinking and weighing our options.
During autonomic nervous system mediated reactions, the only option is survival. No time to think.
The basic physical response in survival mode is a generalized protection “stance”.
Just picture yourself in a fetal position for a minute.
This is what your autonomic nervous system, in its survival-wisdom, wants you to do during times of ANS-activation. Tuck yourself into a fetal position and protect your vital organs.
As many of you probably already know, these moments of ANS-activation can happen routinely without actual threat to your survival. There’s probably no one chasing you and yet, your body might be in a stress-aroused state right now. This means there is a low-grade signal traveling to your brain, suggesting that you might be better off in that fetal position.
But of course, most of us have to ignore that impulse and carry on. So instead, what happens is that the muscles involved in the fetal response become tense…but with no perceivable outward change.
This physiological arousal state impacts many parts of our biology. But in particular, it also changes our physical body in subtle ways. Those changes add to our overall mechanical load or stress.
This added strain does not show up on our radar until the load exceeds capacity. Capacity for mechanical stress can be different for everyone. It can even be different at different times for the same person, which is why it’s often so confusing.
When I see patients in pain, there is always some degree of ANS-activation under the surface.
And until we address this low-grade drive to be in a fetal position, I find pain is often unable to fully resolve.
Recently I had a patient tell me about a terrible stretch of head and neck pain that lasted for 5 solid days. Feeling sick from the pain, she was unable to leave her bed for more than just minor self-care. On the 5th day for whatever reason, she decided to watch a mindless TV series. This is something she explains, she would never normally do. My patient was amazed to find that midway through the shows, her pain was completely gone! She let herself become immersed in the show and something about that allowed her nervous system to re-set.
Now, I’m not saying that in every situation simple distraction is the answer. But for this patient, the experience of immersion into a TV show highlighted what she would never have noticed otherwise. The dominance of her ANS-activation was playing a big role in keeping this particular pain episode alive. Her body was launching an unconscious nervous system reaction.
I had the advantage of working with her body soon after this 5 day stretch of pain. This allowed me to witness some of the residual mechanical bracing that often accompanies this ANS arousal state.
Mechanical bracing in our body is exactly the physical response to stress that I want to bring your attention to.
It seems to be the body’s desire to be in a fetal position that can create this bracing pattern.
Bracing in the neck:
Imagine that you’ve just heard a loud noise above your head. You become alert to the possibility that in a fraction of a second something might fall on you…
What does your body do?
Yes, you duck, don’t you?
Everything contracts and becomes more compact. Think of all the muscles involved in that ducking action. Those are all the muscles that are tense and alert when your ANS is looking out for your survival.
Unfortunately, it’s common to get stuck — almost frozen — in this muscular activation pattern.
Bracing in the low back:
Imagine again a loud noise, maybe this time coming from behind you and quickly growing closer. What does the rest of your body do?
This time maybe your focus is more on protecting your vital organs. You tuck your whole torso as you brace for impact…
Are we just sophisticated pill bugs wanting to roll up at the slightest threat?
When my patient with the 5 day long stretch of pain was on my table, I was reminded of how strong and persistent the muscular reaction to our autonomic nervous system can be.
Even though she wasn’t in pain anymore, her neck was still frozen in flexion. This means all the muscles in the front of the neck were tense. They were grabbing on and causing her head to look down to her chest even while her whole body was resting on the table. The chin-tuck is something that happens when we have a nervous system alarm reaction. It’s the first part of the “pill bug response”.
An alarm-experience that may have occurred many decades ago can leave the body with a bracing-style holding pattern. We can be completely unaware of this until our capacity to tolerate it is exceeded. Maybe we have our 3rd or 4th car accident. It’s not nearly as severe as the first two. But the ANS reaction this time, compounds on years of existing bracing from those past experiences.
The existing bracing was under our radar because the body was handling it. But what it was handling was actually less-than-ideal bio-mechanical stress right on the edge of tolerance. Alarms just didn’t go off until that last “straw” from accident #3 or 4 nudged it over the edge.
Steps you can take:
When you are suffering any kind of back pain, think first about uncurling from your pill-bug response.
Your brace-for-impact reaction might be making things worse. Or it could just be keeping them from resolving.
The act of uncurling is easier with deep breaths — in and out of the belly as well as the chest. Deep breathing will let your brain and nervous system know that the “threat” is gone.
The way that breath expands the rib cage, and relaxes the belly also can naturally restore your un-curled torso shape. Think: ‘belly out and buttocks back.’ If this feels vulnerable then you’re doing it right!
While you’re at it, don’t forget to un-tuck your chin. (There’s a whole other article cooking to help you address the epidemic of our looking-down-posture. Work and school has us holding our head in this positioning almost all day long. This is the shape that we associate with an alarm state most of the time. What an interesting feedback loop we might be creating!)
Un-tucking the chin means, you need to take breaks to look up. Literally move your gaze upward.
I tell all of my patients: Imagine looking for the horizon. Maybe you’re watching a sunset or maybe a sunrise? Take a moment to step into that mindset, and you’ll be doing more than just correcting the mechanical strain.
This article first appeared on the Return to Health, P.S. blog at www.returntohealth.org/blog
You’ll find over 100 illustrations and photos detailing more tips and tricks just like this in my award-winning book, The Everyday Pain Guide Volume 1 “Put Out the Fire”.
- Rodrigues ACZ, Messi ML, Wang ZM, et al. The sympathetic nervous system regulates skeletal muscle motor innervation and acetylcholine receptor stability. Acta Physiol (Oxf). 2019;225(3):e13195. doi:10.1111/apha.13195
- Jänig W., Baron R. (2007) Sympathetic Nervous System and Pain. In: Schmidt R., Willis W. (eds) Encyclopedia of Pain. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-29805-2_4327
- Roatta S., Passatore M. (2008) Autonomic Effects on Skeletal Muscle. In: Binder M.D., Hirokawa N., Windhorst U. (eds) Encyclopedia of Neuroscience. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-29678-2_474
