Your Brain and Your Pain: Understanding the Mind-Body Link

Wellness Concept

Your Brain and Your Pain: Understanding the Mind-Body Link

From the Healing Bridge Physical Therapy

July 2008 Wellness Notes

By Allison Suran PT, GCFP


…actions readily become associated

with other actions and with various states of mind…

Charles Darwin, Expression of The Emotions In Man and Animals

You’re out on a walk with your best friend, it’s a beautiful day, your family is thriving, you’re enjoying your work, and life is good. Suddenly you trip and twist your ankle. You pause for a moment to breathe through the pain, your friend helps you up, and with your arm around her shoulders she helps you hobble home. Arm in arm, laughing and giggling, until you can RICE (Rest, Ice, Compress and Elevate) your ankle with your favorite cocktail and wonderful conversation. You remember your ankle exercises from your previous physical therapy, and everything heals without complication in 6-8 weeks.


You’re at work, you haven’t been enjoying your job for months, they make you work long hours without enough pay. Things are stressful at home, your two young children need lots of attention and you worry about daycare. Your boss is on your case about missing work when they are ill. Your husband isn’t helping around the house like he should. Your father’s health is declining and you worry about him and Mom. Suddenly you bend and twist, and you feel a pull in your back. You keep working, but when you awaken the next morning you can’t get out of bed. Your head swirls with the added stress, the doctors send you for different tests, and each one tells you different things. You haven’t got the time or money for all of this, but you’re in the system now. Weeks pass, and you still have pain. You’re making even less money and are worried about losing your job. Weeks turn into months. Why aren’t you healing?

Research in the fields of neurology, psychology, pain, biology, and physics are all making exciting discoveries about how our systems respond to pain. One of the most important findings for patients experiencing chronic pain, is that the context of your environment significantly influences the amount and duration of pain you perceive. This “context” can include external factors such as extreme heat or cold, sounds, and sights. Your mental and emotional state can also play a significant role in both your experience of pain, and your recovery.

What the research suggests is that if you experience pain or injury in an environment of stress, the brain will perceive this stress and begin to relate it to your pain. One of your brain’s primary functions is to ensure your survival. When it is interpreting pain signals and stress signals simultaneously, it will literally insert additional stress receptors in the region of the pain. Although physiologically your tissues begin to heal, the on-going signals of stress will continue to trigger the new receptors in the region AND thus, they trigger the perception of pain. Long after your tissues should have healed, you may still be experiencing pain from these hypersensitive nerves, that are being triggered by chronic stress.

In this example, “stress” is the internal dialogue of worry, fear, frustration, anger, or any array of emotions that may be a response to life. Most people carry on an internal dialogue which, for the most part, they are not even aware of. It may be thoughts about how you are planning to fit everything into your day; mentally listing an item at the store, or remembering to get gas, or go by the bank, or post office. It may be thoughts about how you are going to juggle bills: pay these two, but I can hold off on these other two for a week, and still not get a late fee… You may be thinking about how you’re going to find time to get out of town to visit your ill parents. Or, worrying about your kids, their school, the things they watch on TV or the computer. AND, it may be all of these things circulating through your brain all—day—long.

In the presence of injury or pain, if some of these thoughts are strong enough, the brain will interpret them as being a part of the injury response. Most of us have practiced our thoughts so mindlessly and habitually, we have no idea that they are adding to our stress and may be interfering with a complete recovery. As we enter the downward spiral of pain, decreased mobility and exercise, the potential for depression increases and the “story” of our pain related stress seems all too justified.

So what can a person do?

First of all, focus on relaxation. Learn to replace the worried thoughts with thoughts of reassurance. Tell yourself, “everything will work out, I’m in good hands, I know I’ll pull out of this, things will get better, this is just temporary.” Practice phrases that bring you a true sense of RELIEF.

There are many practices that support relaxation and learning to be mindful of our “stories” of stress. Meditation, deep breathing and Feldenkrais® are all excellent ways to both relax and learn to notice our thinking patterns. Some people can turn to spiritual practices. Prayer, certain meditations, contemplation, and other practices have all been scientifically proven to positively affect recovery from injury and disease.

The other important thing is to keep MOVING. Even in small ways. Injury can easily lead to a downward spiral of inactivity. Often movement or exercise at the level that you are accustomed to causes more pain, so many folks just give up and stop. DON’T STOP! The best thing for these “hypersensitive nerves” is movement. Nerves need blood flow, space and movement to be healthy. When you stop moving, the tissues get congested, the nerves get sticky in these congested tissues, and the blood flow and oxygenation is poor. Good circulation can begin to heal these hypersensitive nerves back to a normal functioning system.

Find the maximal amount of movement you can tolerate and DO IT! Even if it’s walking for only 5 minutes 2 times per day, it’s a great start! What you want to do is “nudge” the pain. Do just enough movement that you can still do it again tomorrow, but not so much that it is too uncomfortable to move the next day. The important thing is that even if you do flare up the following day, that you still do some kind of movement. At this point, you are re-training your nervous system to trust that movement does not have to be the cause of your symptoms. It’s a way of you gaining trust in you again. Once you have successfully started some kind of movement/exercise, then, very gradually increase it, and DON’T STOP. Yes, this takes commitment, but it’s far better than the alternative.

The Mind-Body connection is no longer for those just seeking “alternative” medicine. Through science, this knowledge is becoming main-steam – although sometimes the wheels of change in our institutions move slowly. Knowledge is power. I hope that you’ll use these new understandings to empower yourself with health and vitality.