The Psychology of Pain

The Psychology of Pain

50 million adults in the United States suffer from chronic pain conditions. Whether due to disease, aging, or injury, these conditions are widespread. For some people living with chronic pain, daily life becomes difficult. They are forced out of education or work and require intense care to be able to maintain functionality.

The changes to life as they knew it — and the pain itself — can take a serious toll on mental well-being and worsen their pain.

What Are the Causes of Chronic Pain?

There are many causes of chronic pain. Though this is not an exhaustive list, it narrows down the different types of chronic pain. Disease, aging, and injury can all be triggers for pain.


Some diseases cause pain in and of themselves. These include chronic migraine, fibromyalgia, and multiple sclerosis. Treating the disease may mean pursuing chronic pain treatment as well.


Typical aging can cause chronic pain, like chronic back pain. However, preventative and proactive treatments can stop this from becoming a permanent state.


After an injury, chronic pain can linger. A car accident or slip and fall may cause a spinal injury that persists in pain or a broken bone that may never feel quite the same again. 

Any one of these causes can change life drastically. Whether it changes a job or makes family life different, these unwelcome changes can be emotional to deal with.

Exhaustion and “Brain Fog”

When you suffer from chronic pain, you may experience exhaustion and what some call “brain fog.” Doing simple tasks — even those that do not directly increase your pain — becomes difficult. You may notice some concentration and memory problems.

These issues occur for two reasons. One is a simple expenditure of energy, while the other happens more on a chemical level in the brain.

First, when you experience pain, you will experience exhaustion for the simple reason that you are tired. Sleep may be interrupted due to pain. Also, doing daily tasks with chronic pain takes more energy.

Second, you may experience something like “brain fog.” It feels like you’re not thinking clearly — and you’re probably not! When your body is spending more energy trying to get normal things done, even cognition can take a hit.

In its most extreme forms, what feels like “brain fog” could be an episode of depression. Depression often accompanies chronic pain conditions. It does not mean the pain is imagined, but rather that the brain and nervous system are now also affected due to exhaustion, limited activity, isolation, and stress.

Using mental wellness tips to improve your emotional well-being — coupled with a treatment plan to reduce your physical pain — can help you return to normal function.

The More You Think About It, the Worse It Gets

The worst fear of many chronic pain patients is being told that it is “all in their heads.” While this is an unfounded accusation most of the time, some science lends credence to the possibility that putting mental energy into thinking or worrying about pain can make it worse.

For instance, someone may experience a flare-up of pain after playing with their grandchildren. It may be so bad that they have to miss work the next day.

The next time they make plans with their grandchildren, they may experience fear leading up to the date that they will be in pain again. They may also worry about missing work again, which is a major stressor for those attempting to retain employment despite the pain.

Psychologically, this does several negative things that increase pain. First, the worry ahead of time can increase stress levels, flooding the body with the stress hormone cortisol. Dysfunctional cortisol releases can cause more inflammation in the body, increasing pain.

Second, the fear of pain causes the patient to resist activities that they previously enjoyed, like playing with their grandchildren. Psychologically, this can lead to isolation and depression.

Finally, a fear of painful movement can lead to an overall reduction in movement. Instead of learning how to move safely to prevent pain, some patients simply stop moving altogether, which is a surefire way to increase pain in the long run.

How Cognitive Behavioral Therapy Can Help

The reason cognitive behavioral therapy is recommended for chronic pain is not that the pain is imagined and therapy will help you “stop making things up,” but rather because the way you think about your pain has real, physical effects on your body. 

Cognitive behavioral therapy can help you think about your pain differently while learning emotional coping skills for this challenge in your life.

When you catastrophize — or think of the worst possible thing that could happen — your body becomes tense, which can increase pain. You also make repeated associations between negative thoughts and normal parts of your life, which are hard to disconnect.

Cognitive behavioral therapy helps you stop the train of negative thoughts. You learn how to replace these thoughts with positive, helpful thinking. In this way, you prevent entrenched thought patterns, like catastrophizing.

Pain also causes anxiety for some. This is because pain is meant to let your brain know your body is hurt. But after months or years of chronic pain, you no longer need this signal. Mental wellness can help manage these unnecessary, stressful signals.

Using Gentle Exercise

Do you remember learning in school about photosynthesis, the process where plants make their own food? Think about exercise in the same way. It’s the process where the body releases its own natural anti-depressants and feel-good chemicals, known as endorphins.

Why do people always say they go for a run when they’re stressed? It’s not because running feels good itself, but rather because the brain releases a powerful flood of endorphins after a tough exercise, like running.

Exercising safely can reduce stiffness and muscle tension. It can also increase your energy levels.

Taking Further Steps to Reduce Pain

If you are suffering from chronic pain, Elite Spine and Health Center can help. Along with tackling your mindset and getting your body moving as much as possible, getting professional care is an important step.  

Make an appointment with Elite Spine and Health Center to begin addressing your chronic pain with chiropractic care today. Easily schedule an appointment online.

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