It is deeply telling that such potent and successful life forms have an intense relationship with hormetic stress. It points to how essential hormetic stress is in enabling all life to thrive. It also points to how important it is that we understand hormetic stress’s role in maintaining our general health. And how vital it is to harness this wisdom when seeking to heal tissues that are stuck in the cycle of chronic pain. 

Hormetic stress supports life on every conceivable scale. From micro-organisms all the way up to entire mountain ranges. And everything in between, including the human body. There are countless ways that hormetic stress benefits the human body. 

Exercise is a hormetic stressor to humans. The most obvious hormetic stress mechanism in our human world is physical exercise. We all know the body needs the constant stress of movement to support healthy muscle and cardiovascular function.

Gravity is a hormetic stressor to humans. Without the stress of gravity, bone demineralises and wastes away. One year in space can leave a cosmonaut with over 20% of their bone mass wasted away to nothing. Without constant mechanical strain, bone stops regenerating itself effectively. 

Heat is a hormetic stressor to humans. Sauna research has shown that when we are exposed to heat, our body’s cells generate heat shock proteins. Heat shock proteins assist with cell repair, muscle repair, inflammation control, improved immunity, cardiovascular function and elimination of free radicals.

Cold is a hormetic stressor for humans. The stress of regular cold exposure has been shown to increase dopamine levels, promote greater well-being, reduce auto-immune inflammation, boost immunity to viruses and boost metabolism. 

Fasting is hormetic stress for humans. Calorie restriction imposes healthy stress on the human machine. Intermittent fasting can trigger a healthy switch from glucose metabolism to ketone metabolism, increase stress resistance, increase longevity, and decrease the incidence of diseases, including cancer and obesity.

Toxins are hormetic stressors for humans. Tannins found in tea are poisons. Yet, in controlled doses like a cup of tea, they are known to protect against cell damage, heart disease, cancer, invading microbes and toxic free radicals. In larger doses, though, tannins are very toxic to the body, like all forms of hormetic stress.

But the question is, how does this all apply in more specific terms to successful chronic pain management?

Hormetic stress can be harnessed and directed to resolve pain, to significant effect, in the overwhelming majority of cases. And the hormetic stressor most vital in healing chronic pains is not heat or cold of chemical stress; it is ‘mechanical stress’.

Mechanical stress can be used almost universally to stimulate the healing and strengthening processes required to resolve chronic pain. To some extent, this is common knowledge, as hopefully, we all understand the central role exercises play in resolving chronic pain. Yet another integral phase of hormetic healing is required (usually before exercise prescription). Where treatments that harness mechanical stress are necessary to trigger healing in painful tissues. If you have found that exercises increase your pain, this should be of some comfort.

There are many pain treatments that leverage hormetic stress to heal tissues and reduce pain. In fact, the overwhelming majority of effective pain relief tools involve the application of mechanical stress to tissues. One example, in particular, serves as an excellent window into how these treatments work.

Quite unexpectedly, it turns out that intense soundwaves can support tissue healing, the same way fire supports giant trees, by delivering a controlled dose of healthy stress that supercharges biological processes.

Extracorporeal Shockwave Therapy (ESWT) was originally developed in the late 20th Century for the treatment of kidney stones. Some brainiacs realised that intense soundwaves travelling through fluid created a shockwave. And that these shockwaves were strong enough to crack a piece of porcelain; but did not harm living tissue. Because tissue is mostly fluid and offers less resistance to the energy. These observations teased the potential for safe,  non-invasive breaking up of kidney stones using shockwaves.

After many years of research and development, ESWT was cleared for use on humans with kidney stones. Which is when something very curious started happening among the test subjects -In the form of unexpected side effects.

After the successful dissipation of their kidney stones, numerous patients felt to compelled to inform the researchers that stubborn pains they had suffered for years had spontaneously resolved. At first, this was understandably dismissed as either placebo or a coincidence. But then something far harder to ignore happened.

A patient with chronic hip pain found that it spontaneously resolved shortly after the treatment of her kidney stones. Which in itself was not unusual, except that the known cause of her hip pain was osteonecrosis (bone tissue death) of her femoral head (upper thigh bone). Then, when x-rays were taken, the bone had spontaneously healed itself. The tissue had mysteriously come back to life. An unheard-of and ‘medically impossible’ event had taken place in her tissues. 

Osteonecrosis of the femur happens when the head of the bone loses connection to its blood supply. This can happen as a knock-on effect of other health issues, including radiation treatment, various diseases, and trauma. And often also occurs for no apparent reason. Starved of its blood supply, the bone tissue literally rots away inside the body, causing inevitable pain and disability.

So the only reasonable explanation was that shockwave treatment had triggered the dying bone to re-establish its own blood supply. Naturally, this warranted significant further investigation.

Fast forward 40 or so years, and ESWT is a gold standard treatment for an incredibly wide range of musculoskeletal pains. Plantar fasciitis, heel spurs, tendinopathies, calcific tendinopathy, stress fractures, Achilles pain, tennis elbow, knee pain, and frozen shoulder are all firmly on the list. And many others, like back pain and neck pain, have yet to be studied in depth but, nonetheless, often respond well in real life. 

Shockwaves’ ability to heal bone and soft tissue means that it has potential application for treating pain almost anywhere in the body. In addition, it has become a standard treatment for erectile dysfunction. And its ability to trigger nerve regeneration has even led to it being studied for its potential use in treating spinal cord injuries, brain damage and Alzheimer’s.

Underlying all this lies a bewildering number of well-documented cell and tissue healing responses. Exactly the type seen when stem cells go to work. New blood vessel growth, new cartilage growth, protein synthesis and the release of various ‘growth factors’ are all well documented. 

All of which come directly from the application of mechanical stress to the cells and the spaces between the cells. The soundwaves create intense pressure, which creates mechanical stress in the tissue, which creates a hormetic response.

So ESWT is a classic hormetic stressor. It imposes healthy stress on tissues and stimulates a wide range of healing responses, which lead to a reduction in pain. Fundamentally acting just like controlled doses of fire do on groves of sequoia trees.

ESWT is very typical of the treatments that most reliably lift people out of chronic pain. Because most of them also apply mechanical stress to the tissue and elicit a hormetic stress response. 

Rehab exercises, deep tissue release, spinal manipulation, yoga, pilates, cupping, fascial release and acupuncture and trauma release exercises are other excellent examples of how home mechanical stress can be exerted in order to heal tissue.

For most pain sufferers, the secret to harnessing these hormetic stressors is to use multiple stressors in conjunction with each other. Combining ESWT with cupping, for example, dramatically improves its already excellent hit rate. In addition, it’s usually necessary to do things in the right order. 

The more passive treatments (i.e. the ones you just lie down on a treatment table and receive) should be used first to heal the tissues and reduce pain. Then, when the pain has reduced, less passive treatments like strength exercises should be used. This helps avoid bad reactions to exercise by ensuring the tissues are sufficiently healthy before strengthening starts. 

The best way to explore all the options is to find a clinic where they systematically mix and match treatments. Failing that, you can curate your own investigation into various hormetic stressors. By hiring a deep tissue therapist, a shockwave therapy practitioner, a chiropractor and an acupuncturist (just for example). In addition, always prescribing your own dose of hormetic stress by keeping your body moving regularly and in healthy ways (as much as you can without causing more pain). 

A strategy of this nature ensures that your painful tissues receive diverse forms of mechanical hormetic stress. The benefits of which should become apparent within weeks, or at least months. Once the treatment combination is right for your body, that is.

Beyond these pain specifics, it’s also well worth considering a more holistic embrace of hormetic stress. Sauna, cold plunges, cardiovascular exercise and fasting have all been of immeasurable benefit to people on healing journeys of all kinds.

Annoyingly, both in and out of pain management, hormetic stressors tend to be uncomfortable. Shockwave therapy isn’t always fun, running up hills isn’t fun, and cold plunges are generally even less popular. So it takes willpower to repeatedly throw one’s self into these fires. But ultimately, a life hollowed out by chronic pain is infinitely worse. So once they fully understand the value of hormetic stress, most pain sufferers find the choice between the two quite an easy one to make.

It’s a mystery why the body needs agitation to be fit .. to heal pain. But it so often does.