Have you ever felt exhausted but unable to relax—as though your body is constantly bracing for something to go wrong?
For some people living with chronic pain, ongoing stress or a sensitive nervous system, it can feel as though the body is spending too much time on high alert.
When someone’s nervous system is already highly protective, touch or movement may feel more uncomfortable or threatening. In those situations, helping the person feel comfortable, informed and in control can be an important part of treatment.
That’s why one of the first things I teach many of my patients isn’t an exercise or a stretch.
It’s how to breathe more comfortably.
Your Stress Response Was Designed to Protect You
Your body’s stress response isn’t bad. It was designed to keep you safe.
Imagine coming face-to-face with a bear. Your brain detects danger and rapidly prepares you to fight, run or protect yourself.
Your heart rate and breathing may increase. Your muscles tense, your attention focuses on the threat and your body mobilizes energy for immediate action.
At that moment, digesting lunch, recovering from a workout and resting deeply are understandably not your body’s top priorities.
The problem is that modern stress doesn’t always look like a bear. It may look like:
- Constant deadlines
- Financial pressure
- Balancing work and family responsibilities
- Poor sleep
- An injury that hasn’t improved or worrying about what your pain means
These situations may not be immediately life-threatening, but the body can still produce a stress response.
When stress remains elevated for long periods, it may influence muscle tension, sleep, digestion, concentration and how sensitive you feel to pain.
Persistent stress can also interact with hormonal, immune and reproductive processes, although these relationships are complex and vary considerably between individuals.
What Does Fight-or-Flight Have to Do With Chronic Pain?
Chronic pain is real. It is not imaginary, and it is not “all in your head.”
Pain is a real sensory and emotional experience involving the nervous system. It is influenced by biological, psychological and social factors, and it often serves a protective role.
When pain continues, the nervous system can sometimes become more responsive to sensory information. Movement, pressure or touch that would normally feel safe may begin to feel uncomfortable or painful.
Think of it like a smoke alarm.
A smoke alarm is designed to protect you from a fire. But if it becomes overly sensitive, it may sound every time you make toast. The alarm is real, even when the level of danger is lower than the alarm suggests.
Some persistent-pain conditions can behave similarly. The nervous system may become easier to trigger, and pain may sometimes continue beyond the expected tissue-healing period or feel more intense than current tissue findings alone would predict.
This does not mean that every case of chronic pain is simply an overly sensitive alarm. Ongoing pain may also involve an injury, inflammation, nerve irritation, disease or other medical factors.
That’s why a proper physiotherapy assessment remains important. It can help identify the physical, neurological, medical and lifestyle factors that may be contributing to your symptoms.
You’re Breathing—but Are You Exhaling?
Breathing happens automatically, but stress and pain can influence the way we breathe.
Our breathing may become:
- Faster or shallower
- More focused in the upper chest
- Irregular
- Interrupted by frequent breath-holding
I catch myself doing this too. During a busy day, I sometimes stop and realize that I’ve been holding my breath or barely allowing myself to exhale.
The goal isn’t simply to bring in more oxygen. In most healthy people, the body is already very effective at maintaining appropriate oxygen levels.
Instead, the goal is to create a quiet, comfortable breathing pattern without taking excessively large or forceful breaths.
When we breathe more quickly or deeply than our body requires, we can exhale too much carbon dioxide. This is called overbreathing or hyperventilation, and it may contribute to light-headedness, tingling or feelings of breathlessness.
Slowing and softening the breath may help restore a more comfortable breathing pattern.
For some people, a gentle breath with a comfortable, slightly longer exhalation may also support relaxation and reduce the feeling of being on high alert.
As you exhale, consider the reminder:
In this moment, I am safe enough to soften.
Try This Gentle Breathing Exercise
Find a comfortable position and allow your jaw and shoulders to relax.
- Place one hand on your lower ribs or abdomen.
- Breathe in gently through your nose, if comfortable.
- Allow your lower ribs and abdomen to expand without forcing the breath.
- Exhale slowly and comfortably.
- Repeat for one to two minutes.
If it feels comfortable, try inhaling for approximately four seconds and exhaling for approximately six seconds.
The breath should feel quiet, easy and controlled—not as though you are trying to fill or empty your lungs completely.
If the count feels strained or creates a feeling of air hunger, shorten it or return to your normal breathing pattern. The exact numbers matter less than keeping the breath comfortable.
***Stop if you become dizzy, unusually short of breath or uncomfortable. If you have a significant heart or respiratory condition, speak with an appropriate healthcare professional before trying paced breathing.
***New, severe or unexplained chest pain or breathing difficulty requires prompt medical assessment and should not automatically be attributed to stress or overbreathing.
Calm First. Then Move.
Breathing exercises are not a cure for chronic pain, autoimmune disease, cancer or other systemic illnesses.
However, they may be a useful addition to rehabilitation for some people and certain pain conditions. Research is encouraging, but the quality and consistency of the evidence vary.
Breathing exercises should complement—not replace—appropriate assessment and treatment. An individualized plan may also include:
- Pain education
- Gradual movement and strengthening
- Hands-on physiotherapy when appropriate
- Sleep and recovery strategies
- Stress-management support
- Appropriate medical care
At PhysioFix & Wellness, we don’t only ask:
“Where does it hurt?”
We also consider:
What may be keeping your system on high alert—and how can we help you feel safe, supported and confident enough to move forward?
When your nervous system has been protecting you for a long time, survival mode can begin to feel normal. You may push through your days, carry tension without realizing it and feel exhausted while still being unable to fully relax.
But the nervous system is adaptable. You don’t have to force your body to relax or blame yourself when it can’t.
Instead, you can begin by giving your body small, repeated experiences of comfort, control and safe movement.
Sometimes the first step toward moving better isn’t pushing harder.
Sometimes it begins with a slower exhale.
Ready to Better Understand Your Pain?
A whole-body physiotherapy assessment can help identify the factors that may be contributing to your symptoms and guide an individualized plan forward.
Feel the Fix. Live the Wellness.
Written by Maria Kristina Antonious, MScPT, BSc Human Kinetics
Registered Physiotherapist and Co-Founder of PhysioFix & Wellness
Ottawa, Ontario
This article provides general education and is not a substitute for an individualized medical or physiotherapy assessment.