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5 reasons why fear and pain cycle is obtacle to heal from persistent physical pain

What if this back pain doesn’t go away?”

“What if it gets worse? “

“What if I can’t work anymore? “

“When I get flare-ups, I get big set backs and I am afraid to do things I did before. “

Is this sounds like you?

This is one thing MANY people with chronic pain struggle with… it’s that FEAR of the pain, Fear of movement (going back to running, gym biking….), Fear of making the injury worse, fear of a flare-up, fear of what could happen next time………..

Fear of pain can be influenced by various factors:

Upbringing and cultural beliefs. Childhood experiences, such as being raised by overprotective parents or those who believe in ‘sucking it up,’ can shape your perception of pain.

The internet can also play a role, as online searches about pain can be overwhelming and anxiety-inducing. It’s important to be cautious, as much of the information about back pain online can be misleading or harmful.

Medical tests like MRIs and CT scans, can be valuble, sometimes reveal issues that lead to more worry and stress

Seeking multiple opinions from healthcare providers can also lead to conflicting diagnoses, adding to the confusion and fear.

Past experiences with pain can linger in the unconscious mind, influencing how we perceive and experience pain in the present. If a previous injury was particularly traumatic, it can amplify the intensity of current pain.

Lastly, limited knowledge or education about pain management can contribute to higher levels of pain perception. Educating oneself about pain and its management can help alleviate some of these fears and uncertainties

This fear causes the stress, worry, anxiety — all of which contributes to more pain.

If you go through physical therapy, or chiropractic treatments to fix your persistent pain problem without addressing the underlying fear and anxiety first, you will not make your treatment successful.

Fear isn’t something that many people recognize or want to acknowledge as part of the pain problem. Because the fear exists on a deeper level of consciousness.

Fear causes the chronic anxiety. The more you think about what you can and can’t do because of pain, obsess about it, scan for it etc.. the more fear and anxiety you will experience.

And fear and anxiety are inseparable from pain. Which means that in order to get in control of the pain, we first need to recognize and conquer the fear.

If you have chronic pain and struggle with fear, we’re going to take a deeper look at that relationship between fear and pain in this article. Plus, I’ll share what you need to do to reduce that fear in order to actually get a handle on pain.

There are 5 main reasons why Fear and chronic pain is problem.

1. Fear Amplifies Pain Perception:

The fear of pain can actually enhance the perception of pain through a process known as fear-avoidance. When you anticipate pain, your nervous system becomes hypersensitive, interpreting normal sensations more intensely. This heightened state of alertness not only exacerbates the existing pain but can also lead to the development of new pain areas, creating a vicious cycle of pain and fear.

Being scared all the time is like carrying a heavy backpack everywhere you go. It makes everything harder, even walking. If you worry too much about pain, you might feel sad or lonely, making the pain feel even stronger. You need to find ways to lighten that backpack and not let fear make your pain feel heavier.

2. Fear and pain cycle causes more stress and anxiety:

Pain and fear are both symptoms of a fight-or-flight response, just like anxiety and panic are symptoms of a fight-or-flight response.

They are the ALARMS your body uses to alert you to a threat, or when the body thinks there’s a threat, in order to get you to take action.

The amygdala, the fear center in our brains, lights up during a pain experience and also drives fear.

You feel more panic, stress, and anxiety because the other physiologic fight-or-flight responses are kicking in – increased heart rate, blood pressure, breathing rate, and muscle tone….

Over time, when you have a hypersensitive nervous system that starts activating your fight-or-flight response, the brain makes a connection between fear and pain and the two become synonymous.

This psychological impact can further intensify the experience of pain, as stress and negative emotions can amplify pain signals in the body. Additionally, chronic stress can lead to increased muscle tension and inflammation, which can worsen pain symptoms.

3. Fear pain cycle has social and occupational consequences:

The fear of pain can have far-reaching effects on an individual’s social life and occupational functioning. It can lead to social withdrawal, reduced participation in enjoyable activities, and impaired work performance or absenteeism. These consequences can diminish quality of life and contribute to feelings of isolation and hopelessness, which are counterproductive to the healing process.

Have you ever wonder, how do physical therapist or back surgeon handles their pain?

Well, Survey on physical therapist at the conference, 96% PT reported back pain in their career, they thought the pain was worse than their patients, but intriguing thing they said they never take time off from work because of the pain.

What do you think could be the reason? They have treated many people with pain, their medical knowledge helps them to overcome the pain much faster so they can use the  exercises and tools and they become effective because they have overcome the fear first.

4. Fear causes the avoidance of beneficial activities:

Fear of worsening the pain or causing further injury often leads a person to avoid activities that are beneficial for their recovery, such as exercise or normal daily movements. This avoidance can result in physical deconditioning, reduced mobility, and a decline in overall health, which can ironically contribute to increased pain and dysfunction over time.

That fear, on a subconscious level, is going to prevent you from moving freely.

If your brain doesn’t think your body is safe and you ignore the fear and do the activity anyway – your brain is going to prevent you from moving normally.

In other words, moving with fear leads to compensatory movement patterns.

Think of it this way, if you have a push pin in your shoe, wouldn’t you walk differently to protect your foot?

In the same way, if you have a fear that squatting, wouldn’t you subconsciously move in a more protective manner?

This happed to me… Over 15 years ago, I injured my back, I subconsciously do not want to backbend when I do yoga. My subconscious brain has modified my movement as a means to protect me.

5. Fear can be Barrier to Effective Treatment:

Fear can serve as a significant barrier to engaging in effective pain management strategies. You may be hesitant to try new therapies, exercises, or lifestyle changes due to fear of the unknown or a lack of trust in the healing process. Overcoming fear is essential to open up to a range of treatment options that can address the underlying causes of pain and promote long-term recovery.

Sometimes, you have to be open minded and need to try new things to help your pain. But if you’re too scared, you might never find out what could really help us. It’s like having a treasure chest but being too scared to open it. We might miss out on the treasure inside that could make us feel better.

In summary, addressing fear is a critical component of managing and healing from persistent pain. By recognizing and tackling the fears associated with pain, you can break the cycle of fear and pain, engage more fully in their recovery, and improve their overall quality of life.

Before you dive in to the any kind of rehab, physical therapy, chiro,  exercise regimen, you need to address fear first.

Here are 3 Ways Breaking Fear Cycle:

    1. You need to fill in the information gaps because when the brain doesn’t know something it automatically assumes the worst. – You need to know why you hurt before you can heal.

    1. You need to practice strategies that will calm the nervous system down, to reduce the fight-or-flight response, take the foot off the gas and put it on the brakes.

    1. You need to gradually address the fear by doing the things that we’re afraid to do because of the pain, but in a way that will not cause the pain to get worse.

In the end, I know you don’t want to be told to manage your stress and I have nothing against stress management strategies but you need to know HOW to tackle your specific pain-related fear and pain-related anxiety before you can beat the pain.

This is a complex process and it’s not something you have to go through on your own.

This is the kind of thing we indirectly work on in my program, the Therapeutic Pain Relief

To learn more about how to minimize your pain-related fear, so you can get more control over you pain, set up the time for Pain Breakthrough session with me today so we can see how we might be able to work together to beat your fear and pain – so you can live a fearless and fulfilling life.

Click here to Reserve the Pain Breakthrough Session today: 

Sources:

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LouwA, PuenteduraEJ, Schmidt S, Zimney, K. Pain Neuroscience Education. Minneapolis, MN: OPTP; 2018
Louw A. Why Do I Hurt Workbook. Minneapolis, MN: OPTP; 2016.
Fritz JM, George SZ. Identifying psychosocial variables in patients with acute work-related low back pain: the importance of fear-avoidance beliefs. Phys Ther. 2002 Oct;82(10):973-83. PMID: 12350212.
Waddell G, Newton M, Henderson I, al. e. A fear-avoidance beliefs questionnaire (FABQ) and the role of fear avoidance beliefs inchronic low back pain and disability. pain. 1993;52:157-168.
Cleland JA, Fritz JM, Childs JD. Psychometric properties of the Fear-Avoidance Beliefs Questionnaire and Tampa Scale of Kinesiophobiain patients with neck pain. Am J Phys Med Rehabil. Feb 2008;87(2):109-117.
Garcia-CampayoJ, Serrano-Blanco A, RoderoB, et al. Effectiveness of the psychological and pharmacological treatment of catastrophization in patients with fibromyalgia: a randomized controlled trial. Trials. 2009;10:24.
Louw A, Diener I, Butler DS, Puentedura EJ. The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain.
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