Pain and the Immune System

We know from many research studies that the way you experience pain depends on your personal situation. Research has shown that the way you feel pain, its intensity and unpleasantness all depends on what’s going on for you – and most importantly – what you think and feel about the situation.

If you expect to feel pain, your brain can actually make you feel pain

Neual Plasticity

What you focus on drives the way your brain adapts and changes. This is your brains neural plasticity. The more time that you spend worrying about all the negative thoughts and feelings surrounding your pain the more entrenched our brains gets at making us feel pain.

Ways to help your immune system

There are actually many things you can do to help yourself to buffer your immune system and improve your pain:

  • Mindfulness meditation is well known to quieten your mind
  • Proper nutrition is important
  • Getting enough quality sleep
  • Movement and exercise
  • Playing – doing things that you enjoy
Video Transcript

We know from many research studies that the way you experience pain depends on your personal situation. 1-3 Research has shown that the way you feel pain, its intensity and unpleasantness all depends on what’s going on for you – and most importantly – what you think and feel about the situation. 1-3

Let me give you an example. In one experiment the participants placed their head inside a sham stimulator (this was a pretend stimulator that did absolutely nothing), but they were told that an electrical current would run through their head.3 These participants reported feeling pain that was proportional to the amount of stimulation they were told they were given, even though they were not given any electrical current at all.3  What this study tells us is that if you expect to feel pain, it can actually make you feel pain. We also know that a lack of knowledge and understanding can in itself cause problems for you, and feelings of pain. The amount of pain you feel can even depend on who is around you. 3 Another study showed that male participants tolerated much higher levels of pain if it was a female who was testing their pain thresholds.3

So, when it comes to pain one thing you need to watch out for is what you are thinking and feeling. 1 4 5 When we identify with, or get wrapped up in, or involved in our feelings and thoughts, this will greatly impact the way our brain makes us feel pain. 6 7 Often, we end up worrying or stressing about the thoughts and feelings, which actually makes everything worse. 8 The more we worry and stress about these thoughts and feelings, the worse it gets. 9 Remember that what you focus on drives the way your brain adapts and changes.10 This is your brains neural plasticity. 11  So, the more time you spend worrying about all the negative thoughts and feelings surrounding your pain the more entrenched our brains get at making us feel pain. 11-16.

Think of it as the stress merry-go-round because this is intimately involved in why people develop pain, anxiety, depression and other forms of physiological and psychological stress. 15-17 

The hormonal or endocrine system is a key player in this stress response.3 15-17  When the alert & danger (sympathetic) nervous system has been activated the hypothalamus releases hormones which makes the pituitary gland release other hormones.15-18  These hormones affect the adrenal glands which produce cortisol.15 Cortisol is known as a ‘stress hormone’.15 19  Stress hormones like Cortisol and Adrenaline are released to protect you when you are in danger! 19  They help to activate your body so that you are ready to fight or flight. 19 But if your brain perceives a threat on an ongoing basis you can end up with persistent high levels of adrenaline and cortisol15 – and this can become a problem. Persistent high levels of Cortisol can slow healing, can lead to depression and feelings of despair and can over time lead to a decline in physical and mental performance.3 And persistent high level of adrenaline can change your nerves and contribute to amplifying the danger/pain matrix tune in your brain3 – making the danger/pain signals seem greater and making them more constant.3

It’s therefore very important to take some time out to look at the way you think and feel about what’s going on for you. Because your thoughts and feelings about what is going on can influence so many of your body’s systems – even your immune system.3  Your immune system can be activated not only by events that happen in the tissues of your body, but also by your brain’s interpretation of those events.3 Your thoughts and feelings actually influence your brains map of the body or your brains inner reality.3 

If your immune system is triggered it is thought to be able to create what is known as mirror pain, meaning you’ll feel pain on both sides of your body.3 20  It will feel like your pain has spread from one area to another.3 20

When your immune system reacts, it produces small immune molecules called cytokines; these float around inside your body and help you to heal.21 Some promote inflammation and some stop inflammation.3 21 Your immune system is supposed to be a good thing, a powerful protection system.22 However, like all other systems, it can also turn into a problem for you if it gets stuck on hyper drive.15 We know that long term stress and pain actually leads to an alteration in the immune system which results in more cytokine molecules that promote inflammation.15 We know that your immune system is closely linked with your alert & danger (sympathetic) nervous system, and responds to cortisol and adrenaline.15 Also, your immune system can turn on parts of your brain that produce more cortisol and adrenalin. So, it can become a vicious cycle.15 

So, what can you do?

There are actually many things you can do to help yourself to buffer your immune system and improve your pain:14

Mindfulness meditation is well known to quieten your mind, to help quieten your worrying about thoughts and feelings and is known to calm the stress response in your body.23-29 There are many online tools that can help and smart phone apps to assist you with starting your mindfulness journey. Proper nutrition is also key 30-32 – with the aim to calm down the inflammation, so that the chemical sensors in our bodies can stop sending inflammatory signals to your brain, so your brain can stop pushing the pain button.30 31

Getting enough good quality sleep is also well-known to buffer against stress and pain.33 34 But bear in mind that stress and pain can often disturb sleep, 33  so just do your best to prioritise good sleep habits that work for you. And don’t underestimate sunshine and water.35 Playing with friends.36 Doing things that you enjoy.14  A hearty laugh in a safe place with friends is the complete opposite to the stress response. 37 This will go a long way in helping your brain to turn down or off the stress and pain music that it has been playing.3 14

But Movement is also essential.29 38 39 If you cannot move due to pain, then even just imagining movement will help you. 40  You need to move the bigger muscles of your body that have been primed for fight and flight, to get rid of the built-up stiffness and tension.38 39   And remember also to get the small muscles around your spine moving too. Yoga or simple daily spinal exercises can be great.9 41 And your family chiropractor can also help you with this.42 43 Chiropractic adjustments help your brain to know more accurately what’s going on in and around your body.43-45 And remember too that chiropractic care is known to alter function in a part of your brain called the Prefrontal cortex46 – which plays a big role in your brains pain matrix. And there’s also plenty of studies that have shown chiropractic care helps people back pain,47-50 neck pain51-53 and some types of headaches.54-56

So if you suffer with chronic pain do your best to stay positive,5 move often,38 39 eat well,30 31 sleep well,33 and go see your family chiropractor57 58 to have your brain fine-tuned too.

  1. Koyama T, McHaffie JG, Laurienti PJ, et al. The subjective experience of pain: Where expectations become reality. Proceedings of the National Academy of Sciences 2005;102(36):12950-55. doi: 10.1073/pnas.0408576102
  2. Apkarian AV, Bushnell MC, Treede R-D, et al. Human brain mechanisms of pain perception and regulation in health and disease. European journal of pain 2005;9(4):463-84.
  3. Butler D, Moseley AM. Explain Pain. 2 ed: Noigroup Publications 2013.
  4. Plaugher G, Long CR, Alcantara J, et al. Practice-based randomized controlled-comparison clinical trial of chiropractic adjustments and brief massage treatment at sites of subluxation in subjects with essential hypertension: Pilot study. Journal of Manipulative and Physiological Therapeutics 2002;25(4):221-39. doi:
  5. Schutze R, Rees C, Slater H, et al. ‘I call it stinkin’ thinkin”: A qualitative analysis of metacognition in people with chronic low back pain and elevated catastrophizing. British journal of health psychology 2017;22(3):463-80. doi: 10.1111/bjhp.12240 [published Online First: 2017/04/05]
  6. Wiech K. Deconstructing the sensation of pain: The influence of cognitive processes on pain perception. Science 2016;354(6312):584-87. doi: 10.1126/science.aaf8934 [published Online First: 2016/11/05]
  7. Michaelson P, Michaelson M, Jaric S, et al. VERTICAL POSTURE AND HEAD STABILITY IN PATIENTS WITH CHRONIC NECK PAIN. Journal of Rehabilitation Medicine 2003;35(5):229-35. doi: 10.1080/16501970306093
  8. Kane MJ, Engle RW. The role of prefrontal cortex in working-memory capacity, executive attention, and general fluid intelligence: An individual-differences perspective. Psychon Bull Rev 2002;9(4):637-71. doi: 10.3758/bf03196323
  9. Eliks M, Zgorzalewicz-Stachowiak M, Zenczak-Praga K. Application of Pilates-based exercises in the treatment of chronic non-specific low back pain: state of the art. Postgraduate medical journal 2019;95(1119):41-45. doi: 10.1136/postgradmedj-2018-135920 [published Online First: 2019/01/14]
  10. Ruffino C, Papaxanthis C, Lebon F. Neural plasticity during motor learning with motor imagery practice: Review and perspectives. Neuroscience 2017;341:61-78.
  11. Kolb B, Whishaw IQ. BRAIN PLASTICITY AND BEHAVIOR. Annual Review of Psychology 1998;49(1):43-64. doi: 10.1146/annurev.psych.49.1.43
  12. Apkarian AV, Hashmi JA, Baliki MN. Pain and the brain: specificity and plasticity of the brain in clinical chronic pain. Pain 2011;152(3 Suppl):S49.
  13. Bayer TL, Baer PE, Early C. Situational and psychophysiological factors in psychologically induced pain. Pain 1991;44(1):45-50. doi:
  14. Hadjistavropoulos TD, S; Goubert, L.; Mogil J.S.; Sullivan, M.J.L.; Vervoort, T.; Craig K.D.; Cano, A.; Jackson, P.L.; Rainville, P.; Williams, A.C.; Fitzgerald, T.D. A Biopsychosocial formulation of pain communication. Psychological Bulletin 2011;137(6):910- 39. doi: 10.1037/a0023876
  15. Hannibal KE, Bishop MD. Chronic Stress, Cortisol Dysfunction, and Pain: A Psychoneuroendocrine Rationale for Stress Management in Pain Rehabilitation. Physical Therapy 2014;94(12):1816-25.
  16. McManus C. Chronic Stress, Chronic Pain, and the Corticolimbic System. Orthopaedic Physical Therapy Practice 2019;31(1):50-53.
  17. Vachon-Presseau E. Effects of stress on the corticolimbic system: implications for chronic pain. Progress in Neuro-Psychopharmacology and Biological Psychiatry 2018;87:216-23. doi:
  18. Loggia ML, Berna C, Kim J, et al. The lateral prefrontal cortex mediates the hyperalgesic effects of negative cognitions in chronic pain patients. The Journal Of Pain: Official Journal Of The American Pain Society 2015;16(8):692-99. doi: 10.1016/j.jpain.2015.04.003
  19. Cardinali DP. Autonomic Nervous Sytem: basic and clinical aspects. Switzerland: Springer International Publishing 2017.
  20. Cheng CF, Cheng JK, Chen CY, et al. Mirror-image pain is mediated by nerve growth factor produced from tumor necrosis factor alpha-activated satellite glia after peripheral nerve injury. Pain 2014;155(5):906-20. doi: 10.1016/j.pain.2014.01.010 [published Online First: 2014/01/23]
  21. Feghali CA, Wright TM. Cytokines in acute and chronic inflammation. Frontiers in bioscience : a journal and virtual library;2:d12-26.
  22. Bilbo SD, Schwarz JM. The immune system and developmental programming of brain and behavior. Frontiers in neuroendocrinology;33(3):267-86.
  23. Black DS, O’Reilly GA, Olmstead R, et al. Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances: a randomized clinical trial. JAMA internal medicine 2015;175(4):494-501. doi: 10.1001/jamainternmed.2014.8081 [published Online First: 2015/02/17]
  24. Goldberg SB, Tucker RP, Greene PA, et al. Mindfulness-based interventions for psychiatric disorders: A systematic review and meta-analysis. Clinical psychology review 2018;59:52-60. doi: 10.1016/j.cpr.2017.10.011 [published Online First: 2017/11/12]
  25. Hassed C. Mind-body therapies – Use in chronic pain management. Australian family physician 2013;42(3):112-17.
  26. Hopwood TL, Schutte NS. A meta-analytic investigation of the impact of mindfulness-based interventions on post traumatic stress. Clinical psychology review 2017;57:12-20. doi: 10.1016/j.cpr.2017.08.002 [published Online First: 2017/08/15]
  27. Majeed MH, Ali AA, Sudak DM. Mindfulness-based interventions for chronic pain: Evidence and applications. Asian journal of psychiatry 2018;32:79-83. doi: 10.1016/j.ajp.2017.11.025 [published Online First: 2017/12/09]
  28. Ong JC, Manber R, Segal Z, et al. A randomized controlled trial of mindfulness meditation for chronic insomnia. Sleep 2014;37(9):1553-63. doi: 10.5665/sleep.4010 [published Online First: 2014/08/22]
  29. Pascoe MC, Thompson DR, Ski CF. Yoga, mindfulness-based stress reduction and stress-related physiological measures: A meta-analysis. Psychoneuroendocrinology 2017;86:152-68. doi: 10.1016/j.psyneuen.2017.08.008 [published Online First: 2017/10/01]
  30. Masino SA, Ruskin DN. Ketogenic diets and pain. Journal of child neurology 2013;28(8):993-1001. doi: 10.1177/0883073813487595 [published Online First: 2013/05/18]
  31. Silva AR, Bernardo A, Costa J, et al. Dietary interventions in Fibromyalgia: a systematic review. Annals of medicine 2019:1-29. doi: 10.1080/07853890.2018.1564360 [published Online First: 2019/02/09]
  32. Quintanilha BJ, Reis BZ, Duarte GBS, et al. Nutrimiromics: role of microRNAs and nutrition in modulating inflammation and chronic diseases. Nutrients 2017;9(11):1168.
  33. Burgess HJ, Burns JW, Buvanendran A, et al. Associations Between Sleep Disturbance and Chronic Pain Intensity and Function: A Test of Direct and Indirect Pathways. The Clinical journal of pain 2019 doi: 10.1097/ajp.0000000000000711 [published Online First: 2019/03/27]
  34. van Dalfsen JH, Markus CR. The influence of sleep on human hypothalamic–pituitary–adrenal (HPA) axis reactivity: A systematic review. Sleep medicine reviews 2018;39:187-94.
  35. Yong WC, Sanguankeo A, Upala S. Effect of vitamin D supplementation in chronic widespread pain: a systematic review and meta-analysis. Clinical rheumatology 2017;36(12):2825-33. doi: 10.1007/s10067-017-3754-y [published Online First: 2017/08/16]
  36. Edwards R, Eccleston C, Keogh E. Observer influences on pain: an experimental series examining same-sex and opposite-sex friends, strangers, and romantic partners. Pain 2017;158(5):846-55. doi: 10.1097/j.pain.0000000000000840 [published Online First: 2017/02/01]
  37. Perez-Aranda A, Hofmann J, Feliu-Soler A, et al. Laughing away the pain: A narrative review of humour, sense of humour and pain. European journal of pain (London, England) 2019;23(2):220-33. doi: 10.1002/ejp.1309 [published Online First: 2018/09/04]
  38. Booth J, Moseley GL, Schiltenwolf M, et al. Exercise for chronic musculoskeletal pain: A biopsychosocial approach. Musculoskeletal care 2017;15(4):413-21. doi: 10.1002/msc.1191 [published Online First: 2017/04/04]
  39. O’Connor SR, Tully MA, Ryan B, et al. Walking exercise for chronic musculoskeletal pain: systematic review and meta-analysis. Archives of physical medicine and rehabilitation 2015;96(4):724-34.e3. doi: 10.1016/j.apmr.2014.12.003 [published Online First: 2014/12/23]
  40. Atlas LY, Bolger N, Lindquist MA, et al. Brain Mediators of Predictive Cue Effects on Perceived Pain. 2010;30(39):12964-77. doi: 10.1523/jneurosci.0057-10.2010
  41. Li Y, Li S, Jiang J, et al. Effects of yoga on patients with chronic nonspecific neck pain: A PRISMA systematic review and meta-analysis. Medicine 2019;98(8):e14649. doi: 10.1097/md.0000000000014649 [published Online First: 2019/03/01]
  42. Galindez-Ibarbengoetxea X, Setuain I, Andersen LL, et al. Effects of Cervical High-Velocity Low-Amplitude Techniques on Range of Motion, Strength Performance, and Cardiovascular Outcomes: A Review. Journal of alternative and complementary medicine (New York, NY) 2017;23(9):667-75. doi: 10.1089/acm.2017.0002 [published Online First: 2017/07/22]
  43. Haavik H, Kumari N, Holt K, et al. The contemporary model of vertebral column joint dysfunction and impact of high-velocity, low-amplitude controlled vertebral thrusts on neuromuscular function. European Journal of Applied Physiology 2021:1-46.
  44. Haavik H, Murphy B. Subclinical neck pain and the effects of cervical manipulation on elbow joint position sense. Journal of manipulative and physiological therapeutics 2011;34(2):88-97.
  45. Holt KR, Haavik H, Lee AC, et al. Effectiveness of Chiropractic Care to Improve Sensorimotor Function Associated With Falls Risk in Older People: A Randomized Controlled Trial. J Manipulative Physiol Ther 2016 doi: 10.1016/j.jmpt.2016.02.003 [published Online First: 2016/04/07]
  46. Lelic D, Niazi IK, Holt K, et al. Manipulation of dysfunctional spinal joints affects sensorimotor integration in the prefrontal cortex: a brain source localization study. Neural plasticity 2016;2016
  47. Ruddock JK, Sallis H, Ness A, et al. Spinal manipulation vs sham manipulation for nonspecific low back pain: a systematic review and meta-analysis. Journal of chiropractic medicine 2016;15(3):165-83.
  48. Goertz C, Pohlman K, Vining R, et al. Patient-centered outcomes of high-velocity, low-amplitude spinal manipulation for low back pain: a systematic review. Journal of Electromyography and Kinesiology 2012;22(5):670-91.
  49. Hidalgo B, Detrembleur C, Hall T, et al. The efficacy of manual therapy and exercise for different stages of non-specific low back pain: an update of systematic reviews. Journal of Manual & Manipulative Therapy 2014;22(2):59-74.
  50. Paige NM, Miake-Lye IM, Booth MS, et al. Association of spinal manipulative therapy with clinical benefit and harm for acute low back pain: systematic review and meta-analysis. Jama 2017;317(14):1451-60.
  51. Bryans R, Decina P, Descarreaux M, et al. Evidence-based guidelines for the chiropractic treatment of adults with neck pain. Journal of manipulative and physiological therapeutics 2014;37(1):42-63.
  52. Wong JJ, Shearer HM, Mior S, et al. Are manual therapies, passive physical modalities, or acupuncture effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the OPTIMa collaboration. The Spine Journal 2016;16(12):1598-630.
  53. Gross A, Miller J, D’Sylva J, et al. Manipulation or mobilisation for neck pain: a Cochrane Review. Manual therapy 2010;15(4):315-33.
  54. Bryans R, Descarreaux M, Duranleau M, et al. Evidence-based guidelines for the chiropractic treatment of adults with headache. Journal of manipulative and physiological therapeutics 2011;34(5):274-89.
  55. Rist PM, Hernandez A, Bernstein C, et al. The impact of spinal manipulation on migraine pain and disability: a systematic review and meta‐analysis. Headache: The Journal of Head and Face Pain 2019;59(4):532-42.
  56. Fernandez M, Moore C, Tan J, et al. Spinal manipulation for the management of cervicogenic headache: A systematic review and meta‐analysis. European Journal of Pain 2020;24(9):1687-702.
  57. Goertz CM, Pohlman KA, Vining RD, et al. Patient-centered outcomes of high-velocity, low-amplitude spinal manipulation for low back pain: a systematic review. J Electromyogr Kinesiol 2012;22(5):670-91. doi: 10.1016/j.jelekin.2012.03.006 [published Online First: 2012/04/27]
  58. Ruddock JK, Sallis H, Ness A, et al. Spinal Manipulation Vs Sham Manipulation for Nonspecific Low Back Pain: A Systematic Review and Meta-analysis. J Chiropr Med 2016;15(3):165-83. doi: 10.1016/j.jcm.2016.04.014 [published Online First: 2016/09/24]

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