Is Stress the Root Cause of Your Chronic Pain?
- Colin O'Banion, DPT
- Nov 15, 2025
- 4 min read
Updated: Nov 17, 2025
I often meet clients in Boulder who have seen multiple doctors, specialists, and therapists in search of relief, but still have no clear answer for their chronic pain. What I consistently find is that most providers are focused on isolated systems: a joint, a tendon, a lab result. But pain isn’t always compartmentalized.
Sometimes the root cause isn’t physical injury. It's stress, or your body’s inability to regulate and recover from it effectively, which is a common pattern I see with chronic pain cases here in my Boulder office. And even when the pain appears mechanical, unaddressed stress can block your system from healing.
And even when the pain appears mechanical, unaddressed stress can block your system from healing.
For over 20 years as a physical therapist, I’ve treated patients across this entire spectrum. Working in New York City for 18 of those years proved to be an effective training ground for working with clients under increased stress. City living, especially in a place as fast-paced as New York, puts constant strain on the nervous system — from noise and crowds to long hours and limited downtime.
And while Boulder may offer more access to nature and an amazing lifestyle, I still see high stress levels among my clients, many of whom are entrepreneurs, creatives, tech professionals and startup founders juggling demanding schedules and high expectations.
Why Your Pain Isn't Just Physical
Many clinicians focus only on the musculoskeletal system (joints, movement, strength, and mobility.) And often, that’s exactly where the issue lies. But when someone has received standard care and pain still persists, we need to ask a bigger question: What else is influencing the body's ability to heal?
This is where I, as a holistic physical therapist and health consultant, take a broader view.
If your pain doesn’t follow expected patterns, and physical structures are intact, it’s time to look beyond mechanics. Through a combination of strategic questioning and hands-on evaluation, I assess the systems that standard physical therapy care often overlooks: nervous system regulation, sleep, recovery, nutrition, emotional health, and more.
A Whole-Person Approach to Chronic Pain
Accurate diagnosis is always the goal when treating anyone with pain. It’s the foundation of efficient, effective care. To get there, we need a comprehensive, whole-person assessment, not just of the musculoskeletal system, but of multiple systems that influence how your body responds to stress, injury and healing.
That’s why my intake process is so thorough and why I send it to you before our first visit. I want to give you time to reflect and respond so I can better understand your full health picture.
By asking key questions about your overall health and lifestyle, I’m able to paint a picture of what’s going on at multiple levels. This builds a complete view of what may be driving your pain — and how we can begin to support your body in returning to a state where healing is possible.
The 7 Pillars of Foundational Health I Assess
To truly understand what’s keeping someone in pain, we need to look beyond symptoms and into the systems that support or block healing.
I use a framework of assessing seven key areas that, when out of balance, can disrupt the body’s ability to manage stress, regulate inflammation, and recover from injury:
Mindset & Emotional Well-Being
Sleep, Recovery & Airway Health
Gut & Oral Health
Nutrient Intake & Hydration
Physical Health & Movement
Environment & Circadian Health
Community & Social Well-Being
I ask a few targeted questions in each area to identify patterns. Then we go deeper into those that appear most out of balance. This helps me connect your pain symptioms to real-life stressors, habits, and health history.
And once we understand what’s out of alignment, we can begin to build a plan to restore balance, reduce stress load, and support your body’s natural healing ability.
Making the Diagnosis Fit the Pain — Not the Other Way Around
After the intake, I validate what I’ve learned with a hands-on physical evaluation, where I assess movement patterns, tissue responsiveness, joint mechanics, and other key physical indicators to ensure your pain fits what we’d expect from a mechanical standpoint.
Things need to make sense.
If someone comes in with neck pain, I expect that pain to follow known patterns: maybe related to tissue strain or joint dysfunction. If it doesn’t line up, and the physical exam doesn't reveal a clear mechanical issue, we have to look deeper.
I begin to consider that contributors like stress, poor sleep, or nervous system overload may be driving the pain response.
Unlike conventional care that may focus only on isolated treatments, my approach connects musculoskeletal therapy with a systems-based evaluation. I address emotional, nutritional, and environmental factors — the full picture of chronic pain. Many clients in Boulder are seeking this kind of holistic relief, but few providers truly connect all the dots.
Final Thoughts: What You Haven’t Tried May Be What You Actually Need
If you've been living with chronic pain and feel like you've exhausted every option, you're not broken. You may simply be stuck in a state your body can't heal from.
Stress impacts the nervous system in powerful ways, and unless that system is brought back into balance, even the best physical therapy for chronic pain in Boulder may fall short.
This is the missing piece for many patients I see. A truly holistic evaluation, thoughtful treatment plan, and supportive education can make all the difference. The first step toward resolution is uncovering the imbalances contributing to your pain and understanding how to shift your system back into a state where healing is possible.
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.
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