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Pain and your emotions
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Pain and your emotions

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Chronic pain can limit your everyday activities and make it hard to work. It can also affect how involved you are with friends and family members. Co-workers, family, and friends may have to do more than their usual share when you cannot do the things you normally do.

Unwanted feelings -- such as frustration, resentment, and stress -- are often a result. These feelings and emotions can worsen your back pain.

I Would Like to Learn About:

  • Mind-body relationship

    The mind and body work together -- they cannot be separated. The way your mind control thoughts and attitudes affects the way your body controls pain.

    Pain itself, and the fear of pain, can cause you to avoid both physical and social activities. Over time this leads to less physical strength and weaker social relationships. It can also cause further lack of functioning and pain.

  • Stress

    Stress has both physical and emotional effects on our bodies. It can raise our blood pressure, increase our breathing rate and heart rate, and cause muscle tension. These things are hard on the body. They can lead to fatigue, sleeping problems, and changes in appetite.

    If you feel tired but have a hard time falling asleep, you may have stress-related fatigue. Or you may notice that you can fall asleep, but you have a hard time staying asleep. These are all reasons to talk with your doctor about the physical effects stress is having on your body.

    Stress can also lead to anxiety, depression, a dependence on others, or an unhealthy dependence on medications.

  • Depression

    Depression is very common among people who have chronic pain. Pain can cause depression or make existing depression worse. Depression can also make existing pains worse.

    If you or your family members have or have had depression, there is a greater risk that you could develop depression from your chronic pain. Seek help at the first sign of depression. Even mild depression can affect how well you can manage your pain and stay active.

    Signs of depression include:

    • Frequent feelings of sadness, anger, worthlessness, or hopelessness
    • Less energy
    • Less interest in activities, or less pleasure from your activities
    • Difficulty falling asleep or staying asleep
    • Decreased or increased appetite that causes major weight loss or weight gain
    • Difficulty concentrating
    • Thoughts about death, suicide, or hurting yourself
  • What to do about your emotions

    A common type of therapy for people with chronic pain is cognitive behavioral therapy. Seeking help from a therapist can help you:

    • Learn how to have positive thoughts instead of negative ones
    • Reduce your fear of pain
    • Make important relationships stronger
    • Develop a sense of freedom from your pain

    If your pain is the result of an accident or emotional trauma, your doctor can assess you for post-traumatic stress disorder (PTSD). Many people with PTSD are not able to deal with their back pain until they deal with the emotional stress that their accidents or traumas caused.

    If you think you may be depressed, or if you are having a hard time controlling your emotions, talk with your doctor. Get help sooner rather than later. Your doctor may also suggest medicines to help with your feelings of stress or sadness.

Related Information

References

Schubiner H. Emotional awareness for pain. In: Rakel D, ed. Integrative Medicine. 3rd ed. Philadelphia, PA: Saunders Elsevier; 2012:chap 100.

Henschke N, Ostelo RW, van Tulder MW, Vlaeyen JW, Morley S, Assendelft WJ, Main CJ. Behavioural treatment for chronic low-back pain. Cochrane Database Syst Rev. 2010;(7).

Smeets RJ, Vlaeyen JW, Hidding A, et al. Chronic low back pain: physical training, graded activity with problem solving training, or both? The one-year post-treatment results of a randomized controlled trial. Pain. 2008;134:263-276.

Kroenke K, Bair MJ, Damush TM, Wu J, Hoke S, Sutherland J, Tu W. Optimized antidepressant therapy and pain self-management in primary care patients with depression and musculoskeletal pain: a randomized controlled trial. JAMA. 2009; 301(20):2099-2110.

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Review Date: 10/14/2013  

Reviewed By: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

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