Stop fearing your pain??
Really?
No one wants to be in pain.
If after an injury, let’s say a knee injury, a doctor told you there was a chance your knee would hurt for the rest of your life it would be a normal response to fear the potential of ongoing pain.
There’s nothing particularly strange or unusual about fearing the prospect of pain.
Unfortunately, fear can be the difference between pain going away once you have healed from an injury, and your pain getting worse and lasting for years.
Why is fear so powerful?
The first thing to understand is that pain is not just an objective physical experience, but a subjective experience that is created in the brain.
Let’s say you fall off your bike and cut your knee. In that moment a signal is sent from the knee to be processed in several areas of the brain including the:
Limbic System, which processes the emotions that arise in response to the pain
Prefrontal Cortex, which processes the cognitive interpretation of the pain
The emotions that arise in response to pain, and the way we cognitively interpret the pain play a huge part in how likely it is that the pain will become chronic.
So, if you fall off your bike and cut your knee and immediately start worrying about how bad the fall was, and what it might mean about your future ability to walk, and start to feel fear about how bad the injury is this can amplify your experience of pain. The more you fear the pain, the more you feel the pain.
So, you feared the pain and it became chronic. How did that happen? Chronic pain is neuroplastic, which means that the pain←→fear cycle actually changes the brain.
The ongoing pain alters neural pathways through a process known as central sensitization. Every time the pain pathways are activated the synaptic connection between neurons are strengthened, similar to how practicing a skill strengthens the relevant neural connections. It’s great that the brain does this when you’re learning to play the piano, but not so great when it means the brain is learning to feel pain, and in the case of chronic pain, the brain is mastering the skill of pain.
Four ways that fear can exacerbate your pain:
Fearing movement
Someone with chronic back pain could fear activities like bending over to pick something up, or lifting heavy objects because they fear this will make their pain worse.
As a result of no longer doing certain movements the individual may experience muscle atrophy and stiffness, which can increase pain and their overall sense of fear of their pain (which in turn strengthens the neural pathways in the brain that correspond with feeling pain in that part of the body).
Hypervigilance
Someone with chronic migraines might become extremely attuned to every little sensation in their head and body that could signal that a migraine is coming on.
Anticipation of greater physical and emotional pain amplifies the perception of the pain, i.e. the pain becomes more painful. Heightened focus on the potential for pain also increases anxiety and stress, which could trigger more frequent or intense migraines.
Catastrophizing
Someone with chronic pelvic pain could fear that their pain will never go away, and that due to their challenges with physical intimacy they will never find someone who loves them and wants to marry them.
This catastrophizing leads to stress and greater attention on the pain, which feeds the pain ←→ fear cycle.
Avoidance of social activities
A woman with fibromyalgia might stop showing up to social events, because she fears that exerting energy will make her pain worse.
She then could start to feel isolated which would worsen her depression and anxiety, which in turn would make her pain worse.
The good news is that neuroplasticity also means the brain can change back to a pain-free state!
So, what can you do to intercept the pain ←→ fear cycle?
Knowledge is Power
🤓 learning more about the neuroscience of chronic pain can empower you to make the changes necessary to heal, and to relate to your pain in ways that reduce fear and anxiety.
Mindbody Coaching and Mindfulness Practices
🧘♀️ learn to shift your relationship to your pain while reducing stress in your mind and body with the support of a professional.
Psychotherapy
🤍 dive deeper into the roots of your anxiety and any long-held beliefs that are feeding the fear.
Do the things you love!
👯 find ways to re-engage with activities you have left behind due to pain. See if there are ways to engage with the activity that feel safe to you, while also practicing not fearing the activity!
My 12 week mindbody program for chronic pain is centered around techniques that help you to stop fearing your pain, so you can stop the pain.
Interested to learn more?
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Wishing you deeper breaths and greater joy,
