Living With Chronic Pain

Fight or Flight

We can’t help but feel stressed and anxious during these difficult times. There’s so much uncertainty. And all that stress impacts our physical health. Even in the best of times it’s a struggle, but the pandemic, financial, work related and political issues have set a new high.

It has clearly exacerbated an already painful situation.

It’s as though we’re in a fight or flight mode 24 hours a day, 7 days a week. A untenable place to be when not suffering from chronic pain, an impossible one for those who do.

Fight or flight is meant for immediate, short term survival needs. When we literally need the ability to fight or flee in order to live another day. In that moment, epinephrine surges throughout our system to give the added impetus required. At those moments our brain, heart, lungs and muscles take priority. The rest are shut down. Who needs the GI or urinary tract then? That’s why in extreme situations bowel and bladder loss occurs.

But that state can’t, and shouldn’t, be maintained. The longer it continues the more our heart works at high capacity, the muscles get shredded and the gut stops functioning. All leading to palpitations, chest pain, indigestion, irritable bowel, shortness of breath, and other symptoms.

Sound familiar?

I’ve seen jaw joints clenched so tightly that teeth have cracked, ears ring and hurt, and chewing becomes difficult. Combine that with neck and shoulder blade pain and excruciating headaches ensue.

Leg cramps and spasms become the norm.

Abdominal bloating, gas, and pain has sent some to the emergency room.

Chest pain so severe it feels like a heart attack.

Shortness of breath that can escalate to believing you’ll suffocate.

One patient years ago was adamant these complaints couldn’t possibly be stress. They were all physical concerns, not mental. And besides, she was dealing with the problems in her life,
“just fine.”

I was taught as a resident when someone tells you they’re “ fine,” you know they are anything but. She was ultimately admitted to the hospital for excruciating chest and abdominal pain. After several days and negative tests the discharge diagnosis was anxiety. A panic attack. None of this can be sustained. So what’s the answer?

Give the body what it is so desperately seeking. Relief. Find safe and appropriate ways to release all that epinephrine and restore balance:

1) Get active! That’s what the body is seeking. Action. Action in any form will give those organs prepared to fight or flee a release. That’s what they have been waiting for – a response. Go for a brisk walk, get on an elliptical, ride a bike, practice yoga, tai chi. Find a routine that works for you. When the body is in sync, moving as a unit to decompress and interact as it’s meant to, the stressors slip away, muscles loosen up and the body and mind act as they should- together. The head no longer fighting for control.

2) Take a long hot bath. Light a scented candle, add some bubbles, epsom salts, listen to relaxing music. . .and float. The heat is therapeutic. I take 2-3 a day. It’s the only way I can survive. I actually take one first thing in the morning before I stretch. Before bed, the bath not only washes away the pressures but so too the pressure points and spasms I’ve been building up throughout the day. It always transports me to another time and place. One where I’m calm and at peace.

3) I used to say get out. Like my post made clear- friends are more powerful than narcotics – socializing and leaving the house, even when all we want to do is stay in bed is always a better option. Now, that’s obviously more difficult to accomplish, but not impossible. Meet outdoors for a barbecue, walk, sit on swings 6 feet apart, throw a ball, swim, or set up small, safe gatherings outdoors and share. Zoom, FaceTime, call, text… whatever it takes to keep in contact with others. When we feel isolated, alone and overwhelmed, pain increases.

4) Pets will keep you sane. And what a wonderful reason to go outside everyday. Set up doggy play dates. It’ll keep everyone active and happy. Pets pick up on our feelings. When we’re agitated, so are they. For all our sake’s, learn to decompress and release the tensions of each day. Studies show just stroking their fur and cuddling drops our heart rates and blood pressures. In today’s tough times they bring unconditional love and attention when more and more are feeling cut off from the world. They can be a literal lifeline to a warm, loving heartbeat.

5) Meditate or use hypnosis to visualize every part of your body. See the blood surging to areas of pain and flushing it out. Feel the muscles release. Find the pent up anger, frustration, anxiety, sadness or heartache and let relaxation take their place. Even if it’s for just a few minutes. Find the time. Then set up ways to decompress during particularly stressful moments throughout the day with a word or action- like tapping your wrist- to immediately reinstate comfort and provide soothing relief. 

6) Get a good night’s rest. Easy to say, harder to accomplish. I know. But it is possible. Start by getting all those achy, painful muscles to stretch, mobilize and release their tension. Exercise! It is the best way to stop the fight or flight syndrome and give the body what it so desperately needs. Then the body can finally turn itself off and sleep. Maintain proper sleep hygiene. If none of that works, talk to your provider. There are wonderful, non-addicting options available. A good night’s sleep makes all the difference. It’s the only time the body restores and heals itself.

7) Listen to music. Whatever picks you up or calms you down. Music is universal and in our genes. It’s a way to communicate, pray, get moving, share and rejuvenate. It truly can soothe the savage beast. By modulating the brain’s limbic system it triggers numerous neurochemical effects. These changes help distract us from negative feelings and promotes relaxation by inhibiting the release of stress hormones. It’s an effective pain reliever too, releasing endorphins – our own feel good, opioid like hormones. Long-term studies have shown music improves the quality of life and reduces the need for pain relievers.

8) When all else fails, just breath! That’s right. Just breath. This one thing will calm and restore balance. Breath in to the count of 5, hold your breath to the count of 5, breathe out to the count of 5 and hold there to the count of 5. Then start all over again. We can’t hyperventilate- breathing too fast due to anxiety that causes a cascade of bodily reactions that exacerbates stress- when we’re breathing correctly. This technique can be done any where, any time, any place.


Stress and anxieties are a part of life. But if we don’t do something daily it’ll build until the measures above won’t be enough. When we heed the warnings, listen and honor our bodies, the results are incredible. Fight or flight? Let’s keep it where it belongs. When we’re in danger.

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