The link between stress and pain is well known: “The research shows that people with higher stress levels generally report more pain,” explained Gabrielle Pagé, a professor in Université de Montréal's Department of Anesthesiology and Pain Medicine.
But the relationship is more complicated than it seems. Sometimes, a stressful situation can have the opposite effect—for example, when a wounded soldier is able to walk several kilometres to safety before feeling any pain.
Stress-management programs are already being used to help people living with chronic pain. “But what was missing, in our view, was an understanding of how pain itself can become a source of stress, fueling the pain cycle,” Pagé said.
Working with Karen Ghoussoub, then a master’s student in psychology, and Sonia Lupien, a professor in the Department of Psychology, Pagé applied Lupien's so-called CINÉ model to investigating how people perceive pain.
Also involved in the research were Pierre Rainville, a professor in UdeM’s Department of Stomatology and a specialist in pain neuropsychology, and Mael Gagnon-Mailhot, then a Ph.D. candidate.
CINÉ, an acronym based on the French words for low control, unpredictability, novelty and threatened self, describes the triggering factors of the human physiological stress response.
These factors set off a cascade of reactions in the body, including the production of cortisol.
The researchers wanted to see whether the factors that trigger a stress response are also associated with pain. If so, they hoped, they could point the way to developing personalized programs to manage pain.
Initial findings of their observational study, funded by the Canadian Institutes of Health Research, were recently published in the European Journal of Pain.
