Fear of pain

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teen boy worried

​​​When people have pain in their bodies for a while, they can develop fear of the pain itself. It is a very normal fear – most people are afraid of experiencing pain. However, fear of pain becomes a problem when it makes you avoid activities that you enjoy or need to do.

We can quickly begin to enjoy life less, and pain can also worsen when muscles become deconditioned because we are not using our bodies properly.

You might be experiencing fear of pain if you have thoughts such as, “I don’t want to move because I am worried it will hurt”, or “I don’t want to move my painful area because I am worried I will injure myself.”

If you begin to avoid situations that you think will cause pain, or protect your painful area by avoiding having it bumped, touched or moved, this could also be a sign that you have developed a fear of pain.

Overcoming your fear of pain

teens walking together

​​First, it is important for you and your health care team to discuss the cause of your pain. In most cases of chronic pain, the pain is not a sign of ongoing damage or injury. Often, whatever started your pain has long healed and what you are left with is a pain signal that keeps occurring even when there is no damage. It is like a fire alarm going off without a fire. After getting an explanation that your pain is not a sign of damage, you need to work hard to gradually stop avoiding situations that you think will cause pain.

If you have a fear of pain, talk to your family doctor. They might refer you to a specialist who will help you to overcome this fear. One strategy that psychologists use is to help you to develop a fear hierarchy (a list of different situations that you avoid because you fear pain). You will learn to gradually work through each of these feared situations and become comfortable with them.

Let's take the example of Annie.

Annie is a young woman with a sensitive arm who avoids crowded areas because she worries about her arm getting bumped. Her pain team has told her that the pain in her arm is actually just her nerves sending a pain signal to her brain – it is not a sign that there of any damage or injury. Rather than protecting her arm, her physiotherapist tells Annie that she needs to expose her arm and the nerves in it to normal stimulation – which means getting bumped and jostled every once in a while.

Annie works with a psychologist to create a list of feared situations regarding her arm being bumped. One fear on her list is walking down a crowded street. Annie practises relaxation techniques with her psychologist and uses them while she is instructed to walk half a block down a crowded street without protecting her arm.

Annie sees that she is able to walk down the street without too much difficulty. She even gets bumped once but does her deep breathing and reminds herself that the pain is just pain – not a sign that she is doing damage or will be injured. Annie feels good that she was able to walk half a block and is ready to try the next step: walking down a full block without protecting her arm.

This type of treatment is called exposure therapy. It works by helping our bodies and brains learn that we will be okay (we will not injure ourselves or cause ourselves more damage) by engaging in feared situations, even when they are painful.

It is important to have the support of a team – therapists or counsellors – to encourage you while you do this work. The same technique can help people with phobias such as a fear of insects or flying.

Last updated: May 2nd 2016