Are your pain beliefs affecting your ability to heal from an injury?

December 08, 2018

Pain belief.
Our pain beliefs and general outlook on life can greatly effect perceived pain.

Pain beliefs can affect our ability to adequately manage stress and pain.

JayDee Vykoukal, DPT

Research has been consistently showing over the last few decades that our pain beliefs play a large role in our perceptions of pain. How we psychologically and physically deal with and manage pain on a day to day basis can be largely influenced by our core pain beliefs system.

The psychology of our pain.

When we experience pain, our ideals (good, bad or somewhere in between) surrounding it can greatly influence how we respond and recover. Some of us will inevitably end up at a doctor or pain specialist looking for answers. Interestingly, it has been shown that the circumstances of that visit are crucial. If a medical professional focuses on the potential negative side effects and what could go wrong rather than focusing on positive treatment and prevention the outcomes can look very different. A positive spin has been shown to instantly improve patient outcomes, regardless of the actual treatment administered. This means that one of the most important aspects of a doctor visit is for it to provide encouragement and education to promote positive pain beliefs.

Pain and the placebo effect.

All this psychological research reinforces the idea of the placebo effect, the premise that believing in the body's ability to heal can be just as effective as other medical interventions (such as therapy, drugs, or surgery). The placebo effect used to be considered as a sign of failure in the medical field when compared to other treatment options, but what it is really showing is just how amazing the human mind really is. The mind and our perception of our healing capabilities has been shown to be a very powerful tool, making positive associations with our pain beliefs important. This means when we get injured or experience pain, it is most important to try to stay positive during the healing process.

The physiology of pain beliefs.

Pain and emotions are closely related to each other and one can largely affect the other. Strong emotions can result in real physical manifestations (like pain!). Unfortunately, pain and negative emotions can cause a bad cyclical pattern. In other words, pain is causing negative emotions such as fear, anxiety and depression. While on the flip side, negative emotions are making the perception of pain (how your brain interprets the pain) worse. It can be easy to end up down a rabbit hole of chronic pain and negative emotions if this process is not halted immediately with adequate support and education.

How it is affected by stress.

Our emotions can also affect stress and hormone levels in the body that directly impact pain perception. A stress hormone that plays a big role in tissue healing is cortisol. Chronic stress can result in high levels of cortisol in the body. This can slow the body's natural healing abilities and even cause further tissue damage and pain. As far as stress and pain go, it is easy to think of examples of how stress levels (good and bad) can either decrease or increase the pain we perceive. For example, "good" stress can can help marathoners push through incredible levels of pain to finish their races. Whereas, chronic "bad" stress can result in depression and make it hard to even get out bed due to intense body aches.

What can I do to prevent chronic pain?

Don't let a sour mood affect your pain! Acute pain is good and a perception that is very important when an injury occurs to force us to slow down and allow healing. Pain also keeps us from further injuring ourselves in certain situations (for example, when we have our hand on a hot surface and immediately move it.) Try to remember this and embrace the pain as you deal with bouts of it throughout your life. Keeping a positive outlook in regards to your pain beliefs can help you navigate these trying times. Pain becomes a problem when it takes over your life long term (greater than 6 weeks) and permanently affects your activities of daily living and quality of life. Just try to remember that pain has a specific short term purpose and does not have to define you beyond that, you are in control!

Stress relief can be key.

Having trouble staying positive in the face of pain? Practice stress relieving and mood boosting techniques such as deep breathing, meditation, exercise, positive social interaction, and mindfulness. If you feel short on time due to your work life (or other obligations) try stress relief for the office. Some simple solutions might be to exercise while at work with equipment like a desk bike or standing desk. Brainstorming ideas to optimize any work or home environment can be helpful in keeping a positive attitude.

What can I do if I already have chronic pain?

How we respond to pain can be a very deeply ingrained and habitual pattern. Our brains are programmed to react familiarly to stimulus. Thus, if you have detrimental and negative associations with pain that are limiting your ability to function on a daily basis, it may require some reflection to find the triggers related to these associations. This will require some deep self evaluation, acceptance, and potential guidance from a trusted medical professional of your choosing. Don't think that you are stuck with chronic pain or that the role of your beliefs have means it's "all in your head." How your brain perceives pain is a very real reaction that can be addressed with the right focus and support.

The body-mind connection is amazing and we are discovering more about it all the time. Embrace this amazing connection and use it to your advantage by keeping in mind that your thoughts, beliefs and attitude have a large impact on how you deal with situations like injury and discomfort. Be strong and try to embrace pain!

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