Chronic pain is a common complaint that affects both the mind and body. In 2011, the Institute of Medicine reported that 100 million American adults experience chronic pain conditions. Worldwide, research indicates more than 1.5 billion people suffer from chronic pain. 

What Causes Chronic Pain?

There is no one cause for pain. Chronic differs from acute pain because pain signals continuously trigger the nervous system, which can last days, weeks or even years. Acute pain fires the nervous system to alert the body of an issue, but the symptoms go away. Here are some of the causes of long-term pain:

-Poor posture
-Muscular imbalances
-Mental and emotional stress
-Faulty gait/movement patterns
-Injuries
-Post-surgery    
-Disease side-effect (e.g., cancer, arthritis)
-Nerve or central nervous system damage
-Previous injuries
-Muscular tension
-Sedentary lifestyle
-Dehydration 

However, some people live with pain without any physical issues or pathology. In this case, researchers have conducted many studies to look at how one’s thoughts and emotional states are linked with pain. 

The Mind-body Pain Connection

Living with chronic pain is not a pleasant experience. Research suggests that those with chronic pain often live in a constant state of fear, anxiety and depression. The mind and body work synergistically to connect the various systems of the body. When the body is in pain, the mind becomes negative and focuses on the pain. When the mind is negative, it is common for chronic pain to flare up. When pain flares up, the body activates the “fight or flight” response, which triggers thoughts about pain and the need to escape the pain. Therefore, when stimulus continuously affects the body, the mind becomes emotionally reactive to and preoccupied with pain. 

It is important to try to discover what triggers the chronic pain. When chronic pain is present, it is ideal to become aware to what physical or emotional stimuli’s affect the body. Ask yourself the following questions to help assess or find the root cause to pain:

-What situations or scenarios trigger my pain?

-What was I thinking at the time my pain flared up?

-What movements (or lack of) did I do that caused my pain to flare up?

-When does the pain not affect my body?

-Are there certain environments (or climates) that trigger and/or release the pain?

-When in pain, does my mood or behaviors change?

-On a 0-10 scale (10 being the worst), how do I rate my pain during stressful situations? 

These questions are beneficial when answered honestly without self-judgment or criticism. 

Mind-body Approaches to Pain

Those who experience chronic pain can reduce (and better manage) pain by stimulating the relaxation part of the central nervous system. Unlike the fight or flight response, which is a function of the sympathetic nervous system, various exercise and mind-body modalities stimulate the relaxation response, which is a function of the parasympathetic nervous system. Entering a relaxing state allows the muscular system to release hormones that positively affect mood. In terms of pain, relaxation techniques can reduce inflammation and train the brain to react differently when pain flares. 

The following modalities are believed to stimulate the relaxation response:

-Yoga
-Pilates
-Meditation (visualization, progressive muscle relaxation, guided imagery)
-Deep breathing
-Aquatic therapy
-Trigger-point therapy (myofascial release)
-Mind-body therapies (acupuncture, massage, Rolfing, occupational therapy, manual ligament therapy)

Mindful-based approaches help emotional reactivity and hypersensitivity toward pain. These exercises and forms of therapy deeply integrate focus, attention and awareness on what the mind and body is experiencing. It allows a person to switch their attention to the task at hand rather than focus or dwell on the pain. When a certain modality is not successful, it is worth trying to find another modality that works rather than surrendering to the pain. Also, these therapies allows people to accept and focus on their strengths rather worry about limitations caused from pain. 

When in Doubt…Breathe it Out

When stressed or when pain presents itself, connect to the breath. The breath allows you to relax at anytime and any place. The next time you’re feeling stressed, try this “emergency” breath exercise: Inhale slowly for five counts (count 1 through 5), matching each inhaled movement with the count. Next, exhale slowly for five counts (count 5 through 1), matching the exhalation with each count. It is ideal to focus the breath into areas of where the pain is experienced. For example, for hip pain, imagine the breath ballooning from the diaphragm, through the belly and into the hip area. This deepens the breath and incorporates visualization techniques. 

Overcoming or managing pain is achievable. The severity of pain determines the length of the journey, whether you’re trying to heal following an injury or better manage your stress. Remember to stay optimistic during times of pain and stress, and always consult your medical professional for the best treatment and care plan.