Your brain and chronic pain

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Your leg muscles ache. Your back is always stiff. Or maybe you’re battling a constant headache. If that sounds like you, you may be among the 20% of American adults living with chronic pain.

But chronic pain is more than a physical problem. People who suffer from chronic pain are more likely to develop anxiety, depression, substance use disorders or other mental health issues.

Many people with chronic pain struggle to get help that works. Some are even told it’s all in their head.

Here & Now recently spoke with Yoni Ashar, co-director of the Pain Science Program at the University of Colorado Anschutz Medical Campus, about how chronic pain and mental health intersect, and what you can do about it.

Here are some highlights from our conversation, edited for length and clarity:

How can poor mental health worsen chronic pain? 

“Being in pain is miserable and can lead to depression and anxiety, but then that creates muscle tension, depression and anxiety, [it] can also drive inflammation in the body, then these circle back and can drive pain as well.

“And so when we feel unsafe, whether it's due to depression, anxiety, PTSD, then that's going to sensitize the whole pain system and turn up the volume.”

How can you retrain your brain to overcome the pain? 

“Pain is an alarm system that lets us know that something is wrong in the body, but sometimes the wiring in the alarm system can get sensitized, so the alarm is going off again and again, even though there's no fire. A false alarm is just as loud and obnoxious and annoying as a true alarm, so no one's making it up. But just this understanding that, ‘OK, my body may actually be OK, intact, healthy and safe,’ it can be a very powerful understanding for people to start to feel safe in their bodies again.

“Getting moving again, starting to do the things that we've been afraid to do. If we've been afraid to play tennis because we're worried it might injure the back or afraid to swim, etc. And there's another major piece here, which is that emotions and stress can really have a major influence on pain as well.

“So fear really limits our behavior or limits what we do often, but it's engaging in those behaviors like going to the pool that they can do two things. One, it can help our body get strong again, and two is that it can help teach our brain that the body is safe.”

You can read more highlights from this interview here, including how chronic pain is diagnosed.

This story is part of Here & Now’s Building Better Mental Health series, where we talk to experts about grief, loneliness, depression, anxiety and much more. Scroll below for five more stories from the series: