When I go to the doctor’s office and they take my blood pressure, it’s almost always high.  There are a couple of reasons for this.  First and foremost, I hate mechanized blood pressure taking machines.  The cuff gets too tight, my fingertips feel like they’re going to pop and I often walk away with a bruise on my upper arm.  So I get cranky, my BP goes up, and the doctor starts asking me about BP medication.  And then my BP goes up higher and I have to steer him or her back in the right direction, the reason I’m sitting in the doctor’s office in the first place: pain, which is the second reason for high blood pressure.

To me, stress and pain go hand in hand.  It stands to reason (in my uneducated brain) that the more stress I have the more pain I’ll have.  My mom always told me my stress took itself out on my body, even as a young child.  The question in my mind is which comes first? Does pain induce stress, or does stress induce pain?

This is actually an important question.  If stress induces pain, then fibro can be treated as gently as stress management, lifestyle changes – new job, a quick divorce…  If pain induces stress, then the pain has to be addressed, which is much more invasive and difficult, not to mention the mechanism for the pain still will not have been identified.

Unfortunately, I’m not sure that stress can be called the chicken or the egg or vice versa.  I suspect there’s a strong interconnection.  The study discussed in Fischer et al (see library) shows that stress is a predictor for pain: “the higher a participant’s stress level at one time point, the more pain she experienced three to four hours later.”  However, they could not find a correlation between pain levels predicting stress.  This seems a little incongruous, since pain can and does have a direct impact on blood pressure, and physical pain (while perhaps not absolutely causing mental stress) definitely causes physical stress, such as blood pressure elevation.

My personal theory intertwines pain and stress in iron bands.  While stress reduction methods will reduce pain, fibromyalgia cannot be cured by stress reduction/dissolution alone.   That indicates to me that stress is not the primary mechanism of fibro.  Looking at immediate reactions between the pain-stress relationship is also perhaps not an accurate way to get a picture of the relationship.  Time is a factor that needs to be explored.

To put it in different terms:  I do not have any direct allergies to food.  I don’t break out in hives when I eat strawberries.  If I eat a peanut I don’t go into anaphylactic shock.  However, there are a variety of foods that I will react to over time.  I avoid products with yeast, such as bread, because if I eat them on a regular basis over a period of a few weeks, I break out.  If I eat products heavy in sugar on a regular basis over a period of a few weeks, my joints swell and become very painful.  But these and other foods require a cumulative effect before I can tell there is something wrong.  It also takes time to “heal” after a reaction.

There is absolutely no reason for me to doubt that stress or pain will have the same cumulative effect.  Sustained, daily stress will create pain.  Sustained daily pain will create stress.  Maybe fibromyalgia patients are caught in a vicious circle, a whirlwind of pain and stress, a perfect storm constantly feeding on itself.