Is this article saying my pain is caused by stress or emotions?

No. This article describes how emotional state amplifies or dampens pain signals that originate from a real physical source. The pain generator, whether it is a joint, a nerve, or inflamed tissue, is still there. Emotional state acts on the volume control for that signal through specific circuits like the periaqueductal gray and RVM. Addressing the emotional and inflammatory layer does not mean the physical layer is being dismissed.

Why does my pain feel worse on some days even when nothing physically changed?

Two mechanisms drive this. Increased connectivity between the default mode network and salience network can pull pain-related threat signals into your ongoing self-focused thinking, and glucocorticoid receptor resistance can leave cortisol circulating without effectively shutting down inflammation. Both of these fluctuate with your stress load, which is why identical days on paper can feel physically different.

Does this mean medication won't work for me if my pain has an emotional component?

Medication still works on the target it was designed for. Anti-inflammatories still reduce inflammation in tissue, and nerve-targeting medications still reduce nerve signal transmission. What they were not designed to do is reach brainstem circuitry, glial activation in the central nervous system, or brain network connectivity. That is why addressing the emotional and inflammatory layer alongside your current medication, rather than instead of it, tends to produce a more complete result.

What can I actually do to influence this brainstem pain circuit?

Structured mindfulness training, consistent breathwork, cognitive behavioral therapy, and consistent sleep have measurable effects on amygdala reactivity, prefrontal regulation, cortisol output, and glucocorticoid receptor sensitivity. These are not generic wellness suggestions. Each one targets a specific mechanism described above, and each requires consistency rather than a single session to produce a measurable shift.

How do positive emotions actually reduce pain, not just distract from it?

Genuine positive emotion activates the ventral tegmental area and increases dopamine signaling, which triggers release of your body's own opioid molecules, beta-endorphins and enkephalins. Those molecules bind to the same mu and delta opioid receptors that prescription opioids target, in the same PAG and RVM circuit described earlier in this article. This is a direct neurochemical effect, not a psychological distraction from the sensation of pain.

Why Do I Keep Getting Pinched Nerves?

Jason Winkelmann

1 hour ago

3 min read

Repeated pinched nerves usually mean something is making your nerves easier to irritate, easier to compress, or both. Common reasons include a second compression site along the same nerve, repetitive postures or movements, and health factors such as diabetes, thyroid disease, or inflammatory arthritis that make nerves less tolerant of pressure.

If each episode has been treated as a one-off and the next one arrives a few months later, the pattern itself is the clue. A nerve that keeps getting pinched is telling you something has not been addressed.

The Mechanism

A nerve's tolerance for pressure depends on two things: how much room it has, and how healthy it is. Room is set by the bones, joints, and muscles around it. Mayo Clinic lists several factors that reduce it, including bone spurs, repetitive hand, wrist, or shoulder movements, obesity, pregnancy, and prolonged bed rest. Health is set by the nerve's blood supply and the chemistry around it, and the same list includes diabetes, thyroid disease, and rheumatoid arthritis.

Diabetes is the clearest example of health lowering tolerance. The National Institute of Diabetes and Digestive and Kidney Diseases states that people with diabetes are more likely to have nerve entrapments than people without diabetes, and that about 25 percent of people with diabetes have some nerve compression at the wrist, though fewer than 10 percent feel symptoms. High blood glucose and blood fats can damage nerves and the small blood vessels that supply them. A nerve with a weakened supply has less reserve, so a pressure that a healthy nerve would shrug off becomes symptomatic.

The other major reason is a second compression site. As described in a review of double crush syndrome, two mild compressions along the same nerve can together cause significant injury, even if neither alone would. Treating the spine without checking the wrist, or the reverse, can leave half of the problem in place, and the nerve flares again the next time it is loaded. The evidence for double crush is still developing and largely drawn from smaller studies, but the clinical logic of checking the whole nerve path holds up.

There is also memory in the nerve. After chronic compression, a nerve can stay sensitized to mechanical stimuli, which means ordinary movements keep triggering it. Recurrence rates are modest in the best-studied case. A physiatry review reports about 8 to 12 percent recurrence for disc-related lumbar radiculopathy, so most people do not keep getting pinched nerves, which is exactly why a repeated pattern is worth investigating.

A recurring pattern is an invitation to look at blood sugar, thyroid function, joint and muscle mechanics, and daily movement habits together, not to keep treating each flare separately.

When It's Something More Serious

Weakness that is getting worse, a foot that drags, loss of bladder or bowel control, or numbness in the groin or inner thighs needs prompt care. Numbness in both hands or both feet, increased thirst or urination, or unexplained fatigue alongside nerve symptoms is worth raising with your primary care provider, since blood sugar and thyroid problems are common, treatable contributors.

How This Gets Addressed

Preventing the next episode means treating the reasons the nerve is vulnerable, not only the current flare.

Chiropractic care addresses joint restrictions along the spine and extremities that narrow the nerve's path, and Massage Therapy and Dry Needling release the muscles and tissue bands where nerves commonly get caught.

Physical Therapy completes the picture by correcting the repetitive movement and posture patterns that keep reloading the same nerve, and Naturopathic Medicine addresses the metabolic and inflammatory factors, such as blood sugar regulation, that determine how much pressure a nerve can tolerate.

You can learn more about our full approach to pinched nerves here.

Most people see fewer episodes once the pattern is identified and addressed, though conditions such as diabetes or arthritis mean those nerves may always need protecting.

Written By:

Dr. Jason Winkelmann

Naturopathic doctor, Chiropractor, Chronic Pain Specialist, and Educator

Frequently Asked Questions

Can diabetes cause repeated pinched nerves?

It makes them more likely. High blood sugar can damage nerves and their blood supply, so nerves are less tolerant of the ordinary pressure that happens at the wrist, elbow, and other tight passages.

Does posture or repetitive work cause pinched nerves to come back?

It can. Repetitive hand, wrist, and shoulder movements are a recognized risk factor, because they repeatedly load the same nerve. Changing how the task is done often matters as much as treating the nerve.

Should I get tested for something if my pinched nerves keep returning?

It is reasonable to ask your primary care provider about blood sugar and thyroid function, because both are common and treatable contributors. A physical exam of the spine and the full nerve path covers the mechanical side.