Separating stress and chronic pain

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Separating stress and chronic pain

Stress makes chronic pain worse, and worsens RTW outcomes. Here are 10 ideas to help alleviate the stress that often accompanies chronic pain.

Written by Tom Barton


A person dealing with chronic pain will often experience chronic stress.

The difficult combination of long-term pain, coupled with the impact it has on someone’s ability to lead a normal life, will take its toll.

In turn, a proportion of people with physical ailments also end up with secondary stress reactions. The individual becomes more anxious, worried, and often becomes irritable and tired. This has a negative impact on close relationships and sleep patterns, and this in turn can spill over into worsening return to work outcomes.

How can people be helped?

  1. Teach the individual to recognise stress and the situations they find stressful. Help them understand their emotional, physical, and behavioural reactions to stress. Keeping a stress diary can help the person learn what their reactions are and how to see them coming.
  2. Explain to them how their illness can contribute to their stress levels, including how negative thoughts can lead to feelings of helplessness.
  3. Provide them tools that can help in coping with stress. These can include exercise, meditation, good nutrition, time management, communication skills, or ways to relax such as:
  4. Relaxation techniques such as progressive muscle relaxation, which involves alternating tension and relaxation of individual muscle groups;
  5. Mindfulness relaxation which involves becoming peacefully aware of thoughts and sensations without judging or reacting to them; and
  6. Guided imagery, which involves focusing on a peaceful image such as waves lapping on the shore with a gentle breeze and the sun shining.
  7. Refer them for cognitive behaviour therapy. In recognising the impact of their own thoughts and behaviours, people can challenge their irrational beliefs and adapt their behaviour accordingly. People are taught how to examine their thinking and explore other rational ways of perceiving the situation.
  8. Help them identify what they can and can’t change. For example, if they are unhappy with the work duties they are performing, they may be able to suggest other tasks that they would like to perform.
  9. Encourage them to recognise a negative interaction in the workplace or within their family that may be causing them stress. Assist them in working out ways of dealing with it.
  10. Help them recognise that some things that can’t be altered, such as the necessity to obtain certificates or good reviews. Accepting things that can’t be changed takes away the element of stress involved in trying to control them.
  11. Convince them that there are sound reasons to be regularly physically active. Evidence has shown that exercise reduces stress levels. Twenty minutes of walking every second day, exercising with others, or taking up an enjoyable pastime such as dancing can make a major difference to a person’s sense of well-being. Getting out and exercising also gives the person some positive focus and a sense of accomplishment and control over their situation.
  12. Remind them of the power of giving to others. Any individual going through chronic pain, multiple appointments and medications, and regular conversations about their situation tends to become focused on themselves. This is not good or bad, it is simply what happens. Helping someone else in a small or large way restores some normality to their life by taking the focus off their situation and giving them a sense of control over their actions.
  13. Involve them with people. Social support reduces the sense of isolation. When a person has long-term problems they tend to become more isolated. They often avoid contact with others and stop going out. Encouraging the person to have a regular activity where they engage with others is worthwhile. Taking pain tablets in preparation for the outing, planning the outing so it is less demanding and communicating honestly with others about their needs can be helpful.


People will try to help, however if help is repeatedly knocked back, the person offering will eventually give up. A person with long-term pain and stress should understand that allowing others to help makes a difference and helps build a positive bond, and help them avoid isolation.

Stress management improves health outcomes and reduces sick leave for people who have a physical disability. Appropriate stress management programs can prove to be cost-effective since they reduce medical and work absence costs, while increasing a person’s wellbeing, which ultimately improves productivity.


*This article is supplied by Return to Work Matters an industry leading in claims management strategies; this article was written by Tom Barton.  All views, opinions and conclusions expressed are those of the authors and/or speakers and do not necessarily reflect the view, opinion, conclusion and/or policy of ExamWorks and its affiliates.

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