Chronic Pain Effects On Your Immune System

Article featured on WebMD

With so many questions right now about the dangers of the coronavirus (COVID-19), you might be wondering how chronic pain might affect the immune system’s ability to fight off disease. Since COVID-19 surfaced a few months ago, we’ve learned that certain people are more susceptible to it than others. Some of the factors that seem to increase severity of the illness include age, smoking, gender, co-existing chronic medical problems, heart disease, hypertension, diabetes, and underlying lung problems from diseases like COPD. This has led to a general view that those with more compromised immunes systems are more likely to experience the worst coronavirus episodes and a higher mortality rate.

Both chronic pain and ongoing stress can impact immune function. According to past research done in laboratory mice at McGill University, chronic pain may reprogram the way genes work in the immune system. In fact, chronic pain seems to prompt changes in the way DNA is marked in special immune cells known as T cells. While it is unclear how much these changes affect the ability of these T cells to fight infection, there does appear to be a strong connection between chronic pain and DNA marker changes on these important infection fighters.

The experience of ongoing pain can certainly trigger a stress response, and if the pain remains chronic, this can lead to a state of long-term stress in the body. Think of the stress response as a combination of neurologic, endocrine, and immune system changes that come together to help the body ward off some type of perceived danger or threat. If the stress response persists, then levels of the hormone cortisol start to rise. Long-term elevations in cortisol levels are connected with a decline in immune system function. As an example, older caregivers have been found to have lower levels of immune cells like lymphocytes, slower wound-healing times, and are more susceptible to viral infections.

Patients with painful autoimmune disorders, like lupus or rheumatoid arthritis, who are treated with immunosuppressive medications, are also at a greater infection risk. By their very nature, immunosuppressive agents inhibit the body’s natural immune response.

Chronic pain can also be associated with other chronic diseases that also impact the effectiveness of the immune system. Factors related to pain like the stress response and prolonged inactivity can lead to  changes in your body that elevate blood pressure and promote weight gain, which in turn become risk factors for developing heart disease, strokes, diabetes, and other chronic diseases. In fact, studies have found the incidence of cardiac disease to be significantly higher in those with chronic pain.To limit pain’s effect on your immune system, do what you can to decrease your body’s stress response. Consider calming down an over-anxious nervous system through simple relaxation techniques like breathing exercises, meditation, gentle yoga, or maybe learn special techniques from a psychologist or therapist. Other ways to lower stress include exercise, getting some fresh air, watching a funny movie, and just unplugging from your devices.

Also, don’t rely only on your immune system – take steps that will minimize your risk of exposure to the virus in the first place:

  • Wash your hands – often – for at least 20 seconds with soap.
  • Avoid touching your mouth, nose, and eyes.
  • Clean and disinfect surfaces in your home and car.
  • Practice social distancing. Stay at home as much as possible, away from public places and crowds.

And don’t forget to practice the practical steps that will keep your immune system working at its best: eat well, try to get plenty of sleep, and stay active.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

11 Chronic Pain Control Techniques

Article featured on Spine-Health

While preparing for any chronic pain coping method, it is important to learn how to use focus and deep breathing techniques to relax the body. Learning to relax takes practice, especially while in pain. It is beneficial to be able to release muscle tension throughout the body and start to remove attention from the pain.

Coping techniques for chronic pain begin with controlled deep breathing, as follows:

  • Setting oneself in a relaxed, reclining position in a dark room and either closing both eyes or focusing on a point.
  • Slowing down the breathing and taking deep breaths, using the chest (and not the abdomen). If distracted, thinking of a word, such as “relax,” to help control the breathing and gain focus can be helpful. This process may be performed by repeating the syllable “re” while breathing in and “lax” while breathing out.
  • Continue with about 2 to 3 minutes of controlled breathing.

After relaxation and focus are achieved, imagery techniques can be used.

Eleven specific imagery and chronic pain control techniques that are effective for pain management include:

  1. Altered focus. This is a favorite technique for demonstrating how powerfully the mind can alter sensations in the body. Altered focus includes focusing attention on a specific non-painful part of the body (hand, foot, etc.) and altering sensation in that part of the body. For example, imagining the hand warming up. This process takes the mind away from focusing on the source of pain, such as in the back or neck.
  2. Dissociation. As the name implies, this chronic pain technique involves mentally separating the painful body part from the rest of the body, or imagining the body and mind as separate, with the chronic pain distant from one’s mind. For example, imagine the painful lower back sitting on a chair across the room and telling it to stay sitting there, far away from the mind.
  1. Sensory splitting. This technique involves dividing the painful sensation (pain, burning, pins and needles) into separate parts. For example, if the leg pain or back pain feels hot, the sensation of the heat is focused upon (and not on the hurting).
  2. Mental anesthesia. This method involves imagining an injection of numbing anesthetic (like Novocain) into the painful area. For example, imagining a numbing solution being injected into the lower back. Similarly, imagining a soothing and cooling ice pack being placed onto the painful area can help reduce the perception of pain.
  3. Mental analgesia. Building on the mental anesthesia concept, this technique involves imagining an injection of a strong pain-relieving agent, such as morphine, into the painful area. An alternative method is imagining the brain producing a massive amount of endorphins, the natural pain-relieving substance of the body, and having it flow to the painful areas.
  4. Transfer. Using the mind to produce altered sensations, such as heat, cold, or anesthetic in a non-painful hand, and then placing the hand on the painful area. This pleasant, altered sensation is then envisioned to be transferred into the painful area.
  5. Age progression/regression. Using the mind’s eye to project oneself forward or backward in time to a pain-free state or experiencing much less pain. Then instructing oneself to act “as if” this image were true.
  6. Symbolic imagery. Envisioning a symbol that represents chronic pain, such as a loud, irritating noise or a painfully bright light bulb. Gradually reducing the irritating qualities of this symbol, for example dimming the light or reducing the volume of the noise, thereby reducing the pain.
  7. Positive imagery. Focusing your attention on a pleasant place, such as the beach, or the mountains, etc. – where a carefree, safe, and relaxed state may be achieved.
  8. Counting. Silent counting is a good way to deal with painful episodes. Counting may include the number of breaths, holes in an acoustic ceiling, floor tiles, or simply conjuring up mental images and counting them.
  9. Pain movement. Moving chronic back pain from one area of your body to another, where the pain is easier to cope with. For example, mentally moving chronic back pain or neck pain into the hand, or even out of the hand into the air.

Some of these techniques are probably best learned with the help of a professional, and it usually takes practice for these methods to become effective in helping alleviate chronic pain. It is often advisable to work on pain coping strategies for about 30 minutes 3 times a week. With practice relaxation and chronic pain control can become strong and last for a long time.

After learning these techniques, chronic pain relief and relaxation can be produced with just a few deep breaths. These techniques can then be used while being engaged in any activity, working, talking, etc. With enough experience, a greater sense of control over the chronic pain and its effects on life can be felt.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Can Chronic Pain Be Prevented?

Article featured on WebMD

Our approach to pain management largely depends on what’s causing the pain. When it’s a byproduct of an ongoing health condition, our focus is finding a good pain management strategy to keep discomfort at a minimum. But when it’s rooted in an isolated event or injury, we can focus not only on treatment, but also the prevention of chronic pain. In situations like this, it’s worth asking – can we keep acute pain from becoming chronic?

The answer isn’t simple – pain is complex and unique to each individual – but there are some things that you can do to prevent pain from taking hold in the long-term. And, similar to other chronic diseases like diabetes and heart attacks, one of the keys to prevention is understanding the risk.

Certain events have been identified as being high risk for developing chronic pain:

  • Surgeries: Though most all surgeries are painful, some are particularly associated with developing chronic pain: mastectomies, thoracotomies (opening up the chest), joint replacements, amputations, and spine surgeries like laminectomies and fusions. With each of these different types of surgeries, it is  common to experience persistent nerve pain related to the operation. There are ongoing studies looking for ways to block excessive nerve irritation during these surgeries, including starting anti-neuropathic pain medications, like pregabalin, gabapentin, and venlafaxine prior to the surgery. If you have a procedure scheduled, talk to your surgeon ahead of time to see if this would be appropriate for your situation.
  • Acute trauma: Acute trauma, like motor vehicle accidents or fall injuries, carries an elevated risk of chronic pain. In my experience, there are usually multiple reasons for this, related to both physical and psychological factors. High-impact injuries from events like falling off of a ladder or getting rear-ended on the freeway cause significant jarring to joints, ligaments, tendons, and nerves of the body, causing a chain reaction that leaves the musculoskeletal system over-tensed and the nervous system over-activated in such an intense way that it may not let up. The emotional response to the injury only serves to further amplify this response. In my practice, behavioral health experts often work with patients to treat anxiety, and even PTSD, that is often associated with going through traumatic injuries. Reducing symptoms of distress early after an injury can play a key role in promoting a quicker recovery and diminishing the chances of progressing into chronic pain.
  • Low back pain: Unlike other acute injuries, like a sprained ankle, where rest is a necessary part of the recovery process, low back injuries don’t heal as well with prolonged bed rest. Recovery is quicker when appropriate movements and a return to typical daily activities are started early on after a back injury.  For added guidance on safe exercises and activities, consider working with a movement specialist such as a physical therapist, chiropractor, or Pilates instructor until you feel comfortable doing things on your own.

Past studies suggest that belief patterns also play a role in the development of chronic pain. For example, catastrophizing, when we think the absolute worst about a given situation, can lead to feelings of anxiety, depression, fear, and hopelessness. Catastrophizing is a known risk factor for developing chronic pain, while feeling more optimistic seems to be associated with improvements in health and well-being. One theory on how chronic pain can develop is known as fear-avoidance, where pain or even the anticipation of pain creates so much fear about further injury, that a person starts to shut down and avoids certain movements. These behavioral changes brought on by high levels of fear are felt to increase the likelihood of developing more widespread and lasting pain. One way that I help my patients change unhealthy perceptions is by approaching things in a very slow and deliberate fashion. Each little accomplishment along the way builds confidence, and the more confidence that is built, the easier it is to wash away negative feelings like fear and anxiety that stand in the way of recovery.

With so many different factors contributing to chronic pain, our approach to prevention should be multidimensional – better education, the right medications, exercise and physical therapy, counseling, and even good nutrition. If you are experiencing acute pain, talk to your doctor about how you might leverage these tools to keep your pain from transitioning into a chronic problem.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday