From the Guidelines
Pain itself does not directly raise white blood cell (WBC) count, but underlying causes of pain can trigger an increase in WBC count. The relationship between pain and WBC count is complex, and it's essential to consider the underlying causes of pain, such as infection, inflammation, tissue damage, or stress, which can stimulate an increase in white blood cells 1. When the body experiences injury or infection, it releases stress hormones and inflammatory mediators that can stimulate bone marrow to produce more white blood cells as part of the immune response. For example, bacterial infections often cause both pain and elevated WBC counts as the body fights the infection. Some key points to consider include:
- Stress from severe pain can also temporarily affect WBC counts through the release of cortisol and other stress hormones
- Tissue damage from trauma or surgery can cause pain while simultaneously triggering an inflammatory response that increases white blood cell production
- It's crucial to understand that if you're experiencing pain and have an elevated WBC count, medical evaluation is necessary to determine the underlying cause, as the elevated WBC is responding to the condition causing the pain rather than to the pain sensation itself 1. Key factors that influence WBC count include:
- Infection
- Inflammation
- Tissue damage
- Stress It's also important to note that laboratory tests, such as WBC count, should be used in conjunction with other diagnostic tools to determine the underlying cause of pain and elevated WBC count 1.
From the Research
Relationship Between Pain and WBC
- Pain can be associated with inflammation, which is characterized by an increase in white blood cell (WBC) count 2.
- Studies have shown that WBC count is elevated in response to tissue damage, trauma, and infection, which can cause pain 2.
- The dynamics of WBC count and its resolution are not well established, but it has been shown that WBC count decays exponentially during inflammatory recovery 2.
Effect of Pain Management on WBC
- Nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen are commonly used to manage pain, but their effect on WBC count is not well established 3, 4.
- Opioids, which are sometimes used to manage severe pain, have been shown to have immunosuppressive effects, but their impact on WBC count is not clear 3, 4.
- Muscle relaxants and antidepressants, which are sometimes used to manage chronic pain, have been shown to have variable effects on WBC count 5.
Psychological Stress and WBC
- Psychological stress, including fatigue, has been shown to be positively correlated with WBC count 6.
- General fatigue score has been shown to be a key determinant of low-grade inflammation, as represented by increases in WBC and neutrophil counts 6.
- The relationship between psychological stress and WBC count suggests that pain management strategies should consider the potential impact on inflammation and immune function 6.