The Psychology of Pain

Orthopaedic & Spine Center

Emily A. Ludwig, PsyD

Pain is the most common reason that patients come to see a physician at OSC, where they treat musculoskeletal conditions of the body. Pain can affect a person’s ability to participate in certain activities, work, how well they sleep, and their relationships with others. As a Pain Psychologist on the OSC Pain Management Team, I seek to help patients cope with the unhelpful feelings and detrimental behaviors that can negatively impact pain.

Pain demands that we pay attention to the noxious stimulus, event or action that makes a us feel pain in a certain area. In this aspect, pain can be helpful because it directs our focus to the injured or diseased area in the body, which can then be treated to achieve relief. But treating pain is not always straightforward. Most people would describe pain as a strictly physical sensation, when in fact this is not the case at all. Pain contains biological, emotional and psychological components that need to be considered. When a patient becomes depressed, anxious, or begins to limit their activity due to pain that has failed to be relieved medically, a behavioral health approach may help with their chronic pain problem.

Every patient will interpret their pain in a unique way.  I can’t tell a patient “don’t think about your pain” because focusing on avoiding thoughts about pain can actually increase pain. Shifting the patient’s attention to something positive can help them avoid thoughts about their pain, and at the same time potentially relieve it.

Emotional reactions to pain can include fear, depression, anxiety, anger and frustration and can intensify physical pain within the neurological system. Every patient differs in how they judge their pain, regulate their emotions, and how in control they feel over their pain. Sometimes patients can have an abnormal focus on possible pain signals, called pain catastrophizing. This can exaggerate a minor injury to feel more painful than it should, creating a sense of fear and anxiety in the patient, causing them to avoid potentially painful situations.

Pain can also be a response that is learned, even in the absence of physical damage or injury. The expectation a patient may have for how much pain they should be feeling can be influenced by their surrounding environment and relationships. If they are prescribed medications or told that their condition is severe from multiple sources, this may contribute to worsening pain. Patients who don’t act upon or adopt negative messages from their environment are likely to have better outcomes.

Having a chronic pain condition is stressful and being stressed out about pain can contribute to other health problems and intensify them. Stress can trigger muscle spasms and tension that may increase pain as well. Some methods used to treat stress are various breathing exercises, meditation, mindfulness, and biofeedback which can teach patients how to control certain body functions. Trying various relaxation methods will help determine which technique works best for each patient.

Every treatment plan I create is specific to each individual and their condition, including a thorough discussion about the patient’s physical and emotional health.  This helps me to decide the right course of action. My goal is to help you find new ways to think about and manage pain, while learning coping strategies to implement in your daily life. My hope is that you will be able to make lifestyle changes with the pain management treatment methods we implement so that you can live your best life possible.