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Chronic Pain

6 Surprising Factors that Contribute to Physical Pain

Some cases of pain are not traceable to a specific injury.

Heike Frohnhoff/Pixabay
Source: Heike Frohnhoff/Pixabay

As we age, it’s common to have little or not-so-little aches and pains. One woman had a sharp pain under her right shoulder blade that didn’t go away despite stretching at home, yoga class, hot baths with Epsom salt, and an hour and a half massage. What did the trick? Working the muscle with a kettle ball.

If your pain has lasted a while, you may need to look at different angles. “By far the most important thing to understand about treating chronic pain is that it is difficult because it almost never has one cause: it is extremely multifactorial. It’s always a game of Whac-A-Mole with chronic pain — but with some really strange moles. And well-camouflaged moles,” writes science journalist Paul Ingraham.

Don’t be surprised if you’re told that your pain isn't due to an injury. Less than 40 percent of chronic pain cases are traceable to an event. About a third are classified as having an “unknown” cause. Below are some surprising sources of pain and how to address them.

1. Emotions

Your pain may be linked to emotions. It's not just a metaphor to use the same language for emotional and physical injury or hurt.

If you spend more time alone than you’d like—or feel people don’t enjoy your company—your body may respond with alarm. Loneliness, which is arguably as bad for your health as smoking cigarettes, seems to increase your vulnerability to chronic pain. And when we're uncomfortable, we tend to retreat into our homes or beds, compounding the problem.

Have you had a romantic breakup or lost a job? Some people may be especially vulnerable to pain from rejection. It's important to understand that the mechanism for emotional pain piggybacks in our brain on the receptors for physical pain. There's even evidence that taking Tylenol can make you less rejection-sensitive. Forgiving the person who hurt you can help as well. You may find yourself having more physical pains when you feel angry and rejected.

The vagus nerve, at the back of your neck, carries signals from the mind to the body and back. If it doesn't function normally, some researchers say that could contribute to the link between childhood trauma and chronic pain, including migraines, years later.

2. Not enough use

It’s counterintuitive, but a workout can drive away muscle pain. Think of a restless boy who starts acting out, punching his kid sister. Get him outdoors on a scooter for an hour and he’s sweet-tempered again. The woman's shoulder pain went away because she hoisted the kettle ball in ways that used her shoulders, chest, arms, and abdomen.

3. Interrupted or too little sleep

Lack of deep sleep diminishes your tolerance to pain. The problem may be sleep apnea, insomnia, or — in a feedback loop — your pain waking you up. First, address sleep problems. Up your aerobic exercise to 30 minutes a day, which will make it easier to get deep sleep. Turn off your smartphone and computer an hour or more before bedtime. Irrigate a clogged nose. You may need a new mattress or a test for sleep apnea.

4. Not enough estrogen

A drop in estrogen also lowers pain thresholds. Vijay Vad, MD, a sports medicine specialist at the Hospital for Special Surgery in New York City and the author of Stop Pain: Inflammation Relief for an Active Life, recommends taking 2,000 mg daily of curcumin. A compound in turmeric, curcumin is a potent anti-inflammatory, but it is hard to absorb in a powder, unless it is combined with a constituent of black pepper. But some formulations, including curry dishes, address that problem. Note that curcumin can interact with anti-coagulant drugs and might be best to avoid if you have gallstones. If you have other menopausal issues, you might talk to your gynecologist about hormone replacement therapy.

5. Low thyroid

Vad recommends that anyone with arthritis or any type of joint or muscle pain that has taken a turn for the worse ask for a “thyroid function panel,” which measures levels of thyroid stimulating hormone (TSH) and other hormones in your blood. A normal TSH is between 0.4 mlU/L and 4.0 mlU/L. Medication can relieve pain within a month, even if your level is considered “borderline.”

6. Lyme disease

If you live in an area where Lyme disease is a problem, find a bulls-eye rash on your body, and have headaches or joint aches, a doctor may give you antibiotics immediately. But some people fail to notice a tick bite or rash. Antibodies against Lyme disease bacteria take 4 to 6 weeks to develop. Wait at least a month to get tested with either the enzyme-linked immunosorbent assay (ELISA), an indirect fluorescent antibody (IFA) test, or a test that provides results within an hour called PreVue. If you get a positive or uncertain result, follow up with a Western blot. What if you got a negative result at the first stage but still have pain or unexplained fatigue? You may have been tested too early, so try again. According to the Centers for Disease Control and Prevention, other tests — such as urine antigen, immunofluorescent staining, and lymphocyte transformation — remain unproven. To get a second opinion, look for a specialist.

You may also want to look into fibromyalgia if you can't pinpoint another cause and you have pain all over your body.

A version of this story also appears at Your Care Everywhere.

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