Expert Blogs | Pain Management
2 Mistakes That Can Make Your Pain Worse

What if I told you that, besides being generally unpleasant (to put it mildly), pain can also be deceiving and misleading? Yes! Pain can play tricks with our heads and fill us with thoughts that can be harmful and hold us back from getting better.

Here are two of the most powerful mind tricks that pain plays on us (they may surprise you!):


Think of catastrophizing as a thought process where you see the worst in a situation and consider only the most negative of possible outcomes. Catastrophizing is often associated with rumination, meaning you keep thinking that something terrible is going to happen and you can’t get it out of your head. This constant negative thinking can then directly impact your feelings and emotions, which means you can start to freak out or get really depressed.

A lot of pain research done over the years suggests that catastrophizing can have a big impact on how we hurt. Not only does catastrophizing influence the intensity of our pain, but it seems to play a significant role in whether the pain becomes chronic or not. In fact, studies have found that catastrophizing can lead to an increased chance of long-term disability.

In some cases, how we interpret the words we hear from our doctors can determine how much we catastrophize. For example, if your physician tells you that you have really degenerated discs in your lower back, you could respond by ruminating that this a “terrible” problem that will never go away and will likely lead you down a path of becoming wheelchair dependent. Or, you could choose to interpret this as a common diagnosis that happens as we get older and decide you are going to do whatever you can to minimize its impact so you can continue to lead an active and happy life. Two different mindsets to the same problem can lead to very different outcomes.

But if you are the person hurting and you don’t have a medical background, how do you know if what you are thinking is reasonable or catastrophizing? This is might be a good topic to bring up with your doctor, especially since research shows that catastrophizing is usually overlooked by most doctors. If you find yourself feeling very worried about anything related to your health, why not let your physician know how you feel and get their perspective on how realistic your fears might be. There is a good chance that your doctor has treated similar situations to yours many times in the past.

If you find yourself ruminating excessively, ask your physician for assistance in learning tools for quieting these thoughts and finding ways you can see your health in a more positive light. Studies show that decreasing levels of catastrophic thinking actually lead to better pain treatment outcomes.

Associating Pain With Harm  

Pain and injury don’t go hand in hand when it comes to chronic pain. Granted, pain is the hallmark sign of an acute injury like a broken bone, and the disappearance of that acute pain is a notable sign of tissue healing and repair. Starting in childhood, our brains learn to equate pain with harm or injury that we carry into adulthood and use as a protective mechanism. But this typical learned behavior can pose a problem for those working to overcome a condition that is more chronic.

When pain triggers this warning alarm, we go through a fight or flight response as a protective mechanism to either fight off or run from danger. But if we go through this type of fire drill every day, then we develop a dysfunctional behavior pattern where we keep our attention focused on a perceived threat that doesn’t really exist. This can leave us feeling agitated, anxious, and fearful, and prevents us from moving on with our day and engaging in otherwise meaningful activities.

Consider the example of neck pain from a whiplash injury. The pain you feel right after getting rear-ended is related to acute tissue inflammation, but feeling neck pain a whole year later is a different matter. When pain is felt with moving chronically tight and sore muscles or joints, that doesn’t mean injury is taking place. Rather, it is a sign that your body has learned to resist such movements and needs to go through a careful process to recondition and retrain certain muscles, tendons, joints, and nerves to behave differently.

But if you continue to avoid turning your neck for many months because of the negative feedback of the pain, then your neck will only get stiffer and hurt even more, and keep you from engaging in meaningful activities. Yes, pain can play wicked games on our minds and hold us back from getting better if we let it! Overcoming this tricky “pain – fear – avoidance” loop is not easy and may require assistance, but the first step is getting to a place where you understand the difference between experiencing pain versus doing something that is actually harmful or dangerous to your body.

With both catastrophizing and the misconception that chronic pain is a sign of further harm, we see ourselves misinterpreting our medical condition to the point of letting it disrupt our lives in very negative and lasting ways. Turning the tide on these two barriers to recovery might be just the thing that helps you find relief.

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Peter Abaci, MD

Peter Abaci, MD

Board-certified anesthesiologist and pain specialist

Peter Abaci, MD, is one of the world’s leading experts on pain and integrative medicine. He is the medical director and co-founder of the renowned Bay Area Pain and Wellness Center and the author of Conquer Your Chronic Pain: A Life-Changing Drug-Free Approach for Relief, Recovery, and Restoration and Take Charge of Your Chronic Pain: The Latest Research, Cutting-Edge Tools, and Alternative Treatments for Feeling Better.

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