How Does Your Mind Alter Pain?

Written by Teo Buzas, PT, DPT

What is the mind?

The mind refers to that part of us that oversees our thinking and choosing. It is with our minds that we ingrain truths or lies into the brain, which is part of the body. Our beliefs affect how we feel because we feel whatever we believe. Dr. Caroline Leaf, a cognitive neuroscientist, states, “Your body/brain is not in charge of your mind. Your mind is in control of your body, and your mind is stronger than your body. When you think, you build thoughts, and these have physical effects on the brain. We can change the physical nature of our brain, and body, through our thinking and choosing. Either for the better or for the worse.”

What is the brain?

The brain is the physical organ that is inside of our skulls. It is a complex organ that is crucial to our thoughts, memories, emotions, pain, hunger, and every process that regulates our body. Your mind oversees your brain. As you think, you choose, and you create habits and neuropathways as well as influence genetic expression. What if our thoughts have remarkable power to change the brain? How much do our thoughts affect our experience of pain? Normain Doidge says it is possible in his excellent book: The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science.We cannot fully control the events and circumstances in our lives, but we can control our reactions. This is not easy, it’s hard work. As we develop the ability as well as exercise our brain “muscle,” we can be aware and take responsibility for our reactions, and through that, change our brains and our health. This affects our experiences of pain, health, and wellness.

We are constantly reacting to circumstances in our lives, including pain experiences.

These circumstances and reactions shape our brains in either a positive or negative direction. In her book Cleaning up Your Mental Mess, Dr. Leaf provides research that an estimated 95% of genes are influenced by our environment and lifestyle factors. Research shows that DNA changes shape according to our thoughts (2). To explore more about this, look into the field of epigenetics. The science of epigenetics shows that our thoughts can control our biology. We can control our thoughts and positively direct genetic expression in our bodies.

How we choose to think affects the health of our brain, our bodies, and therefore, our overall health. Research shows strong correlations that upwards of 75-98 percent of mental, physical, and behavioral illnesses are rooted in one’s thought life (1). The brain is not fixed, and it can change even in the most challenging neurological situations (e.g. stroke). Neuroplasticity means the brain can change. It is malleable and adaptable. This is hopeful!

What about BELIEFS and EXPECTATIONS regarding pain, injury, and activity?

What is a belief? Beliefs can be defined as something one accepts as true or real; a firmly held opinion (Oxford Dictionary). Our understanding and beliefs about pain significantly inform and influence our pain experiences. Expectations about future pain outcomes are among the strongest predictors of pain, pain behavior, and treatment outcomes (3).

Read that line again, more slowly, and give it another moment.

That is a powerful statement on predicting pain and outcomes. A substantial body of research has shown that what one believes and does about their musculoskeletal pain predicts how long the pain will last and how disabled they will be by it (4). Wow! This is an important aspect of recovery! Studies involving individuals without musculoskeletal pain at baseline have found that unhelpful beliefs predict the incidence of future disabling pain (5,6). Among people with acute musculoskeletal pain, unhelpful beliefs predict the severity of disability over time (7,8,9).

So, we see that beliefs about the identity, cause, consequence, controllability, and timeline of musculoskeletal pain influence the pain experience. It influences problem-solving behavior, activity levels, and emotional responses.

Health belief theories, that have been well established in research, show that what we believe about health and illness can predict the onset of symptoms of illness. This is the power of the mind!

How people view the influence of their diagnosis on their pain and daily life activities can impact patient expectations about their prognosis (10).

When we experience pain, we immediately rely on a set of beliefs to make sense of what we are feeling. Some of these beliefs are related to what the pain is, what caused it, what the consequences of the pain are, how long it will last, and what we should do about it. Many of our beliefs are formed by our previous experiences, seeing others deal with the same symptoms or what we have been told by family, health professionals, and society.

Some questions to consider for self-reflection:

• What beliefs do I hold about the body and musculoskeletal pain?
• Where did these beliefs come from?
• What are my own experiences with pain?
• What is my coping response to the pain?
• What is my emotional response to the pain?

It is important to get a good understanding of pain. Here are some common beliefs held by society about the body and pain (4):

Inaccurate and unhelpful beliefs influence the pain experience and other aspects of an individual’s life and health. Beliefs about the body and pain influence the pain experience and our response to it. Look for positive, evidence-based beliefs about pain. Look for ways to get empowered to understand pain and have freedom from it by knowing what you can do. Then, do it.

At Bridging the Gap Physical Therapy, we are here for you. We offer full body evaluations and discuss your treatment plan. This includes your diagnosis, your goals, and the plan for getting you there. Find out more by speaking to our team today at 239-676-0546.

1. 98 percent of mental and physical illnesses come from our thought life: www.stress.org/americas.htm
2. Leaf Caroline. Switch on your brain. (Grand Rapids, MI: Baker Books, 2015).
3. Fink et al. Pain psychology in the 21^st century: lessons learned and moving forward. Scand J Pain 2020; 20(2): 229-238.
4. Caneiro J, Bunzli S, O’Sullivan P. Beliefs about the body and pain: the critical role in musculoskeletal pain and management. Brazilian Journal of Physical Therapy 2021;25:17-29.
5. Picavet HS, Vlaeyen JW, Schouten JS. Pain catastrophizaing and kinesiophobia: predictors of chronic low back pain. Am J Epidemol. 2002;156(11):1028-1034.
6. Alyousef B, Cicuttini FM, Davis SR, Bell R, Botlero R, Urquhart DM. Negative beliefs about back pain are associated with persistent, high levels of low back disability in community-based women. Menopause. 2018;25(9):977-984.
7. Martinez-Calderon J, Struyf F, Meeus M, Luque-Suarez A. The association between pain beliefs and pain intensity and/or disability in people with shoulder pain: a systematic review. Musculoskelet Sci Pract. 2018;37:29-57.
8. Jay K, Thorsen SV, Sundstrup E, et al. Fear avoidance beliefs and risk of long-term sickness absence: prospective cohort study among workers with musculoskeletal pain. Pain Res Treat. 2018.
9. Elfering A, Muller U, Rolli Salathe C, Tamcan O, Mannion AF. Pessimistic back beliefs and lack of exercise: a longitudinal risk study in relation to shoulder, neck and back pain. Psychol Health Med. 2015;20(7):767-780.
10. Bonfim IDA, et al. ‘Your spine is so worn out’ – the influence of clinical diagnosis on beliefs in patients with non-specific chronic low back pain – a qualitative study. Brazilian Journal of Physical Therapy. 2021;21(44).