Anxiety is a physiological state characterized by cognitive, emotional, and behavioral components producing fear and worry. It is a condition characterised by a future-orientated perspective with an anticipation of potential threats.
The positive relationship between anxiety and pain is well known in clinical settings (Grachev et al, 2001, Colloca & Bendetti, 2007). Anxiety levels have been shown to predict pain severity and pain behavior in acute and chronic pain, as well as pain after surgical procedures. (Van den Hout et al. 2001, Woo, 2010)
Anxiety can lead to hyper-vigilance, which is a heightened sensory sensitivity to our environment. In this case, the brain is more alert to incoming information and can display heightened responses to these incoming sensory signals. With regards to pain, the brain can be more likely to react to changes in our body tissues, which it can perceive as more dangerous than it really is.
Brain imaging studies have revealed that following negative expectations of pain, the perceived intensity of a painful stimulus increases due to activity in certain brain areas (Colloca & Bendetti, 2007). In a study by Ploghaus et al. (2001), anxiety relating to pain resulted in an increased pain response. They found through brain imaging that the areas of the brain, more specifically the hippocampus, which is an area involved with pain processing, was also affected by anxiety. They showed that during anxiety, activity of this area was heightened which resulted in an increased pain response.
In a common condition such as low back pain, anticipation of pain, fear of movement, and a concern regarding how the pain will impact the life of the sufferer can produce states of fear and anxiety. This can negatively affect the pain experience by sensitising the central nervous system, including the brain, which can in turn result in a heightened level of pain.
Although anxiety has a negative effect on pain, there are techniques, which have been shown to reduce the perceived threat value of the pain. These include; education regarding ones pain and condition, challenging negative and unhelpful thoughts through cognitive behavioural therapy and engaging in mindfulness practices such as meditation and yoga ,which help to reduce the sensitivity of associated brain areas involved with pain and anxiety.
Physiotherapist Chris Davies consults Tuesdays and Saturdays
For appointments call – 9997 2121
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Grachev I, Fredrickson B, Apkarian A (2001) Dissociating anxiety from pain, mapping the neuronal marker N-acetyl asparate to perception distinguishes closely interrelated characteristics of chronic pain. Molecular Psychiatry. 6. 256-260
Ploughas A, Narain C, Beckman C, Clare S et al (2001) Exacerbations of pain by anxiety is associated with activity in a hippocampal network. Journal of Neuroscience. 21(24) 9896-9903
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Woo A (2010) Depression and anxiety in pain. Reviews in pain. 4(1) 8-12