10 Hidden Stressors That Might Be Fueling Your Chronic Pain (And What to Do About Them)
- Colin O'Banion, DPT
- 6 days ago
- 4 min read
If you've been struggling with chronic pain in Boulder that hasn't responded to physical therapy, chiropractic care, injections, or massage, you're not alone. Many patients come to me frustrated, wondering why nothing seems to work. Often, the true driver of persistent pain isn't just mechanical. It's stress, and it may not be obvious.
My Approach: Start with a Thorough Evaluation and Assessment
As a holistic physical therapist, every initial session begins with a comprehensive intake and assessment. Patients fill out detailed questionnaires ahead of time, allowing them to reflect and me to gain insights before we even meet.
By asking questions that give me insight into that person’s overall health and lifestyle I am able to paint a picture of what might be going on at several different levels. This is why my intake is thorough, comprehensive, and provided in advance of my first session with the patient.
I assess physical patterns, but if your pain doesn’t match known tissue or joint dysfunction patterns, I dig deeper — looking at stress-related drivers like sleep, emotional health, and nervous system regulation.
If someone comes in with neck pain, I expect that pain to follow known patterns related to tissue strain or joint dysfunction. If it doesn’t match those patterns, I begin to consider that something else — like stress, poor sleep, or nervous system overload — may be driving the pain response.
Below are ten types of stress that I assess with my patients when mechanical treatment alone doesn't resolve their symptoms. You may not think of these as stressors, but your nervous system does, and this can often result in chronic pain.
10 Often-Overlooked Stressors That Might Be Keeping You in Pain
1. Emotional & Psychological Stress
Anxiety, trauma, perfectionism, negative self-talk, relationship conflict. These don't just weigh on the mind — they create muscular tension, disrupt sleep, and amplify pain sensitivity.
2. Physical Stress
Overtraining, poor posture, old injuries, or even just sitting at a desk for hours. Your body can interpret poor mechanics as a chronic stress load.
3. Sleep Stress
Short sleep. Light sleep. Interrupted sleep. Your pain processing and recovery capacity both plummet without deep, restorative rest.
4. Nutritional Stress
Low protein. Low hydration. Blood sugar swings. Inflammation from processed foods. Lack of key minerals and vitamins. Excessive or deficient caloric intake. All of these affect healing.
5. Environmental Stress
Noise. Air quality. EMFs. Bad lighting. Poor ergonomics. Your surroundings impact your system more than you think.
6. Chemical / Biological Stress
Mold, allergens, alcohol, smoking, medications, chronic infections. Many people with mysterious chronic pain are unknowingly dealing with one or more of these.
7. Social Stress
Loneliness. Isolation. Lack of community. Humans are wired for connection, and disconnection shows up physically.
8. Financial / Occupational Stress
High-demand jobs, job insecurity, money stress, burnout. These can create a chronic fight-or-flight state in the body.
9. Cognitive / Information Stress
Constant multitasking, device addiction, zero downtime. Your brain has a limit.
10. Existential / Spiritual Stress
Lack of meaning or purpose. Feeling disconnected from your core values. This can contribute to physical tension and systemic stress.
So What Can You Do About It?
If we identify stress as a contributing factor in your pain, we start with education and empowerment. I’ll help you understand how your autonomic nervous system (ANS) works — and how to calm it so your body can shift into healing mode.
The autonomic nervous system (ANS) is like your body’s automatic control center, running things you don’t have to think about, such as heart rate, breathing, digestion, and blood pressure. It has two main branches: the sympathetic system (“fight or flight”), which revs you up in times of stress, and the parasympathetic system (“rest and digest”), which calms you down and supports recovery.
In a healthy state, your body smoothly shifts between these two modes. But when stress or illness keeps you stuck in “fight or flight,” it can disrupt sleep, digestion, and overall health.
As a physical therapist and health consultant, I work with my patients to look at the big picture. Many of my clients come to me after seeing a number of different practitioners: doctors, nutritionists, chiropractors, looking to pinpoint an isolated issue. Through integrative care, I help clients regulate their system using both physical and non-physical tools.
If stress is a pain-causing issue I'll work with clients on techniques I use, but I may also refer patients to trusted local therapists in Boulder when emotional stress needs additional support.
I also educate the patient on effective, inexpensive tools (many are free) that they can learn to assess and manage their stress. Education and empowerment is key.
Stress Supporting Tools I Use or Recommend:
Breath work (Control Pause, exhale emphasis, CO2 tolerance)
Physiological Sigh
Vagus nerve stimulation techniques
Active relaxation practices (body scan, qigong)
Rolling & Stretching
Cold and Heat Exposure with controlled breathing
Calming supplements such as Magnesium, Ashwagandha
Skilled manual therapy + E-stim
Craniosacral therapy, acupuncture, and massage
Final Thoughts: When Chronic Pain Isn’t Just Physical
If you’ve been chasing down the same pain with the same treatments and nothing seems to be working, it might be time to zoom out. Not all pain is purely physical. Often, it’s your body signaling deeper imbalance.
Stress isn’t always obvious. It doesn’t always feel like panic or anxiety. But it can live in your system in quiet, persistent ways: affecting how you sleep, how you recover, and how your body processes pain.
That’s why every client I work with gets a thorough, whole-body evaluation. We look at the physical. We look at the emotional. We look at the lifestyle. And from there, we build a plan that actually makes sense for your life and your body.
Because pain that hasn’t gone away doesn’t mean you’re broken. It might just mean no one’s put the full picture together yet.
How to Connect with Me:
Colin O’Banion, Doctor of Physical Therapy
Colin is a licensed Physical Therapist and founder of Colin O’Banion Physical Therapy in Boulder, Colorado. With 20 years of experience, he specializes in solving complex and chronic pain cases through a root-cause, integrative approach. Colin combines advanced manual therapy, shockwave therapy, dry needling, and movement re-education to help clients return to the activities they love. His one-on-one practice is dedicated to clients seeking lasting solutions when traditional PT has fallen short.
Comments