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Monday, 20 November 2017
This page aims to answer some of the questions you may have about the Chronic Pain Management Service and coping with your pain. If cannot find the answer you need, you can contact us on 01473 703435 and we will do our best to answer your query.

Chronic Pain Management Service FAQs

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I’ve been told in the past that the pain is ‘all in my head’ or ‘all in my mind’. Is this true?

The person who told you this may have got the wrong end of the stick! Psychological factors do have an important role in chronic pain – but not in the sense that people who suffer pain are making it up or imagining it. ‘All in the head’ or ‘in the mind’ is the phrase people often use when they are referring to psychological factors – things like thoughts, beliefs, feelings, mood or ‘the unconscious’.

Chronic pain almost always has a physical cause. Over time, the stress and upset of living with a chronic pain condition can have an impact over how you feel (your emotions and mood) and what you do (your behaviour). Some of these psychological and behavioural changes can be unhelpful, and can even make the pain feel worse. As time goes on you are affected not only by the chronic pain, but also by these psychological factors. A simple diagram can show how this can work:

In the past doctors believed that the mind and body were separate and did not affect each other. Advances in psychology and medicine have proved that this is not the case. In fact the mind and body are linked together very closely indeed, and psychological factors have a huge and very real influence over the body

So how does this relate to pain? Life events (including living with chronic pain) cause emotions. Emotions like stress, sadness, fear and anger influence pain in two important ways:

  1. Because of the links between mind and body, negative thoughts and emotions have a direct influence on how the pain system works and can cause pain to increase.
  2. These emotions affect how you feel and what you do, and how you manage and cope with your pain. How well you cope with and manage your pain impacts upon how much the pain interferes with your life.  

In a similar way, too, thoughts and beliefs influence your pain. They do this by impacting on what you do (your behaviour) and how you feel (your emotions). Here are two examples:” with

“Thoughts and emotions (like stress, sadness, fear and anger) influence pain in two important ways:

  1. Because of the links between mind and body, negative thoughts and emotions have a direct influence on how the pain nerves work and can cause increases in pain level.  
  2. Thoughts and emotions affect what you do, and how you manage and cope with your pain. How well you cope with and manage your pain impacts upon how much the pain interferes with your life.  

Here are two examples:

Tim believed that no matter what he did he could never have any influence at all over his pain (thoughts and beliefs). Thinking this made him feel hopeless, frightened and angry (emotions). He couldn’t see the point of learning any pain management strategies, and gradually he stopped seeing friends and doing hobbies (behaviour). He started to become depressed (emotion), and the lower he felt the worse his pain felt and the more strongly he believed he was unable to do anything about it.

Usha believed that she was able to take steps to improve her pain and to live well despite it (thoughts and beliefs). She read up on pain management strategies and put them into practice, and aimed for a healthy lifestyle (behaviour). In this way, she was able to help herself to manage the pain more effectively, so she felt more positive and less stressed (emotion). As a result, her pain felt more manageable, took up less of her attention, and worried her less. In turn, this strengthened and proved her belief that she was able to influence the pain. 

In this respect, then, psychological factors (what is going on in your head / mind) do influence pain. But the pain is not ‘all in your mind’ – in fact it is in your body, but what goes on in your mind (your ‘psychological state’) has a direct and very real effect on it.

The good news is that because of the close links between mind and body, you can use your mind to influence your pain. By coming to understand the role of psychological factors (like thoughts and emotions) on your individual pain experience, you can learn to use the relationship between your mind and body to positively influence your pain. Examples include learning to think positively, or to use relaxation techniques.