"I hit the breaking point last Friday when my boss bumped up this massive project by a whole week," my 29-year-old patient Jennifer told me during our initial consultation. "I mean, who does that? With two kids at home, social obligations, and an hour commute each way, it became the final straw and I just…snapped."
Jennifer landed a position at a high-pace Manhattan law firm last year and was determined to pave a steady career path. But that determination often meant 70-hour workweeks, a frantic office environment, and deadlines getting pushed up. Chronic stress took a massive toll on Jennifer’s weight and health. She had put on about 20 pounds, suffered frequent migraines, and developed lower-back pain that was really affecting her quality of life.
Use your stress response only when you need it.
As a Manhattan-based doctor of physical therapy who focuses on pain management, I frequently see these (and so many other) repercussions of a high-stress environment. "If this were a one-time event, your body would release the hormone adrenaline to increase your heart rate and respiration, thus increasing blood flow and oxygen to tissues," I told Jennifer. "Adrenaline prepares you for fight or flight. You wouldn’t normally feel pain during an acute stress response." Unfortunately, Jennifer’s stress wasn’t a one-time situation; it was frequent, cumulative, and chronic, which kept her stress hormone cortisol elevated when it shouldn't have been. Cortisol has a similar effect as adrenaline, but it's more potent and lasts longer.
Jennifer’s physician prescribed a low-sugar diet, some stretches she could do at the office, and Xanax to reduce stress and anxiety, but she wasn’t satisfied with those pat solutions, which is why she visited me. Unfortunately, most doctors overlook a huge reason patients like Jennifer struggle with pain and weight. Yes, diet and exercise are important, but the third pillar of pain management comes from a source few professionals speak about: your brain.
Pain has more to do with your brain than your body.
Pain is created in your brain—and nowhere else! Not in your joints, muscles, or any other part of your body. Understanding this idea often becomes an epiphany for patients. Your brain makes your safety and survival its highest priority, protecting you and alerting you when it thinks you might be in danger. And stress is just one way your mind works to protect you. When you feel stress, you get a burst of energy to run and flee from danger or stand your ground and fight it.
The fight-or-flight mechanism is a wonderfully evolved human system, that is, until it works against you. If your brain perceives that a physical injury puts you at risk, it often creates pain. And pain signals to the body that something is potentially threatening and informs you that protection is needed. Unfortunately, your brain is extraordinarily adept at noticing even the smallest danger signs—not just physical injuries—and for Jennifer, that "urgent" email triggered a domino effect that ramped up stress hormones and, subsequently, pain.
You can change your mindset to get a handle on pain and stress.
"To change this, you need to shift your mindset about persistent pain," I told her. Most of the danger signals your brain receives each day aren't actually threatening your safety. And cortisol, the stress hormone I mentioned earlier, takes a stressful thought or emotion and turns it into a physical response; in Jennifer’s case, this showed up in the form of migraines and lower-back pain.
The good news is that you have the power to change how your brain works. Of the many strategies I had Jennifer use to shift her perspective to reduce stress and pain, some of my favorite are:
Once Jennifer acknowledged the numerous factors influencing her brain (and how her brain was responding), she learned effective coping strategies to overcome those negative thoughts and emotions to positively influence her brain and refocus on healing.
Visualizing herself in control and knowing all the uncomfortable feelings would pass helped Jennifer ease stress and re-channel her energy in a more positive direction.
3. Reframing thoughts.
Jennifer realized negative thought patterns triggered and exacerbated her stress. So instead, she shifted her attack thoughts into thoughts of support: A thought like I feel overwhelmed and out of control became I'm grateful for this moment in which I can focus and do my best.
Repeating a mantra or calming words helped Jennifer relax because it gave her brain something positive to focus on. Some of her favorites were release, relax, peace, silence, and love.
Emotional freedom technique (EFT) is a psychological acupressure technique that optimizes your emotional health. EFT is based on the same energy meridians used in traditional acupuncture for over 5,000 years but is done without needles. Instead, simple tapping with your fingertips inputs kinetic energy onto specific meridians on your head and chest while you tap a specific problem and voice positive affirmations.
Through nutrition, movement, and mindset, I helped Jennifer dial down stress levels. Where do you begin? You can start by taking my pain quiz here and then instituting these simple but powerful strategies above to reduce stress, eliminate pain, and help you reach your goal weight.