Does stress/anxiety influence pain?

If we look at current literature, stress and pain are often interconnected.

Acute stress and acute pain often coincide and may influence each other. Pain increases stress and vice versa.

Acute stress modulates/amplifies painful stimuli resulting in both increased or decreased pain experience.

Depression and anxiety are also very common in patients with chronic pain. Those with anxiety and depression disorder are much more likely to have disabling pain.

Why is this important?

Since we know that stress/anxiety may amplify pain, we should be very careful when educating/transferring our knowledge to patients. We don't want to scare patients needlessly! 

Labelling injuries can have an impact on perceived seriousness of the injury. For example, labelling back pain as lumbar sprain or episode of back pain decreases the need for MRIs and enhances recovery expectation. Whereas labelling back pain as arthritis, degeneration or disc bulge increase MRI utilization and may cause catastrophizing thoughts and kinesophobia(fear of movement)!

This likely increases pain perception.

So be chose your words wisely folks! Don't scare patients!

Physio Summum Brossard