Fear of pain during physical activity

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Sometimes, people with chronic pain begin to fear movement because they worry that it will only increase their pain. This can lead them to avoid movements and activities in case it makes pain worse. However, the opposite is true: avoiding movement actually makes pain worse and may make movement more painful in the future.

Check out Mark’s experience with fear of pain below.

How to manage your fear of pain

One of the first steps to managing your fear of pain is to understand the nature of your pain. Remember from the session about chronic pain that pain acts as an alarm system for your body under normal circumstances. With injury, the alarm system goes off and information from the site of danger or injury travels to your spinal cord and brain through your body’s nervous system. When this alarm message reaches your brain, it is evaluated so your brain can decide how threatening the message is and whether or not the sensation of pain is necessary to keep you safe. With chronic pain, there are changes in how your spinal cord and brain process and interpret the signals.

Sometimes pain persists even after your body has healed or the danger is gone. Chronic pain can be like the smoke alarm in your kitchen that goes off even when there is no fire. Say, you leave toast in the toaster for too long, causing it to smoke. There is no fire, but the smoke alarm warns you as if there is a fire anyway. Depending on the sensitivity of your kitchen smoke alarm, it may go off really easily and it may even go off on a hot day for no reason at all. When your pain persists, your body’s alarm system can become more sensitive – just like a very sensitive kitchen smoke alarm – and it can go off even when there is no injury and no danger. When this happens, alarm messages are sent to your brain and it decides that a threat exists and pain is necessary to protect you. This is called nervous system sensitization.

When you move and are active and you feel pain, it may make you worry that you are damaging your muscles or other tissues. But this may just be because of the sensitivity of your nervous system and false danger messages. If you are often afraid of increasing pain with activity and avoid activity as a way to avoid pain, it is important to gently begin moving and returning to normal activities again. Doing this can help reduce the sensitivity of your nerves and result in less pain, and you can be more active.

Tips for managing your fear of pain

  • Even though your pain may not always give you an accurate warning of danger, it is still your brain's way of reminding you to do something – to move more or practise coping strategies such as deep breathing or relaxation. Your healthcare team can give you some specific movement exercises that may help you move better and, over time, reduce your pain.
  • Increasing your overall activity level gradually is another important way you can turn down your alarm system. Consider what activity (or activities) you can prioritize so you can balance your energy properly.
  • Set SMART goals to help you overcome your fear of pain.
  • Use patience, persistence and an activity plan​ to help you reduce your pain and improve your overall sense of wellbeing. You can ask your healthcare team to help you with your plan.
  • Do activities at a steady and regular pace in a way that works for you.
Last updated: May 2nd 2016