Chronic pain, a relentless, often misunderstood and always unwelcome companion for millions of individuals worldwide. If you or someone you know has it, you will already understand that it’s a complex puzzle. The answer to whether it resides in our mind or body isn’t straightforward. The fact is, more often than not – it’s both.

Body and mind connection

Cost of Chronic Pain

  • Pain is the second most common reason for claiming incapacity benefit, costing £3.8 billion annually in the UK
    £584 million a year is spent on prescriptions for pain (in the UK alone)
  • For instance, the annual healthcare costs for someone with chronic low back pain (LBP) are double those of people who don’t have LBP but are similar in their health in every other way (£1,074 vs. £516) (www.csp.co.uk)

Before we dive more deeply in to chronic pain, it’s useful to know it’s rarely one treatment for a solution. Most of the time, multiple interventions are needed alongside physiotherapy to treat the condition. It’s also well worth noting that on average 25% of people with chronic pain lose their jobs as they struggle to manage the pain and work. That’s huge!

Pain at desk

The Mind Matters

When we experience pain initially, it’s our body’s warning signal to our brain—a biological alarm system to protect us from harm. However, chronic pain (persistent pain lasting more than three months), becomes increasingly less straightforward. It’s a multi-faceted phenomenon rooted in both our biology and psychology.

Brain Rewiring: The brain, our ultimate control centre, plays a pivotal role in chronic pain. It can become rewired over time, amplifying pain signals. This rewiring often occurs after an initial injury has healed. When it’s receives lots of the same sort of signals such as pain, it can learns to get really efficient at reading them more sensitively and quicker. This rewiring can be changed as normal movement returns, which is where physiotherapy is really useful.

Emotional Impact: Emotional distress such as with anxiety, depression, or stress can trigger or exacerbate the pain.

Pain Memory: Our brains remember pain. Even after an injury is resolved, the memory of pain can linger. This ‘memory’ can resurface as pain, even when there’s no obvious physical cause.

Pain Perception: The way we perceive pain is individual and is also affected by our past experiences, expectations, and cultural factors. It’s a highly subjective experience. For example, let’s take a completely fictional character (we’ll call her Clare)…

Story Time!

Clare grew up with a Dad who had had back pain for as long as she can remember. As a young office worker and keen runner, he injured his back one day from bending to pick up an object from the floor and never fully recovered. Clare’s childhood memories were of her Dad being in pain, avoiding moving due to pain and developing other health issues over the years as he lived a more sedentary life.

Fast forward 20 years and Clare now works in an office and has joined a gym. A couple of months in to the membership she bends down to take her shoes off and feels a sharp and severe pain in her. For the next couple of weeks she uses prescribed painkillers to help her move but is still struggling. At this point Clare may have a number of thoughts or beliefs about her pain:

  1. Going to the gym caused her pain.
  2. When she moves it hurts, so must be doing damage to the area.
  3. What if it’s genetics and runs in the family?
  4. She must be careful in the future as her back must be weak and it will ‘go’ again.
  5. This could be the start of a life of back problems now.

It’s easy to see how Clare might stop going to the gym, might get stiffer and weaker, might start to interpret every small ache or pain in her back as something to fear and to stop doing the things she enjoys. Chronic pain can happen to anyone for a whole host of reasons, and it’s rarely because of the physical body alone.

Outline of the human body

The Body’s Story

While the body isn’t the whole issue, some of the aspects to take in to consideration when thinking about the stuck cycle of chronic pain are:

Inflammation: occurring in conditions like arthritis, fibromyalgia, and autoimmune diseases can lead to chronic inflammation, causing ongoing pain.

Nerve Damage: conditions such as neuropathy result from damage to the nervous system, causing ongoing pain signals being sent to the brain.

Muscle Tension: especially over the long-term often due to poor posture or repetitive strain, can result in chronic pain. Stress and anxiety can exacerbate muscle tension too. The more pain we have, the higher we tend to hold our shoulders, making the muscles more tight, increasing the our pain and stiffness which is turn can increase our stress…

Structural Issues: chronic pain often starts with a physical injury or issue and these can take longer to heal if someone has co-morbidities like diabetes.

Physiotherapy can help to address underlying physical issues, improve posture and joint position, and can help to reduce muscle tension. It can help you feel like you’re getting back control of your body and managing your symptoms. We have one life and if there’s any chance in making that better, take it. When it comes to chronic pain – check out local physiotherapists and speak with them so you feel confident that they will understand. We’re a nice bunch 😀

The Mind-Body Tango

We’ve established that chronic pain is usually in both in our mind and body, and that the amount of affect each has on our pain can change over time. There are proven techniques and treatments to help calm the mind and may in turn reduce our perception of pain.

The Placebo Effect: Our mind has the incredible power to alleviate pain purely by believing that a treatment will work with clinical studies proving this time and again. Having an open mind rather than assuming it won’t work from the offset, can have a very real effect on the likely outcomes.

Mindful Practices: Practices like meditation, yoga, and deep breathing help calm the nervous system, reduce stress, and ease chronic pain.


Pain Management:
Cognitive-behavioural therapy (CBT) and talking therapies can help us reframe our thoughts about pain and develop healthy coping mechanisms. There are amazing therapists out there – if you’re in the UK you could start by checking out www.bacp.co.uk for a list of qualified counsellors and therapists.

Therapy, counselling

Impacts on Daily Life

Chronic pain can be a life-altering experience. affecting everything from work to relationships, our sense of self and even life expectancy. Feeling that loss of control and sense of self is debilitating. Physiotherapy supports and enables people with chronic pain to remain in or return to work and along with the following, can give you back some of that sense of control, alongside other treatments.

Mental Health: With depression and anxiety common in those with chronic pain, it’s essential to address the mental aspects for holistic well-being. List the things you feel you can do for your mental health: such as speaking with someone you know and trust or trying to spend time outside regularly if you can! Even if it’s sitting outside the back door, walking around the block or at an outdoor space that you enjoy, without headphones and listening to the world around you. Maybe you have a local library, coffee shop or park nearby so you can be there out in the world. It’s so easy to get stuck in our own heads and can be so incredibly lonely in there.

Social Isolation: Check out social media. What local groups are there on Facebook or Instagram, what free activities or otherwise are happening locally? Are there recommended walks to try, or a voluntary activity to help, maybe there’s a charity that works with others with health conditions. If you have first hand experience of what it’s like to live with a health condition that affects everything, it’s useful to hear how they’ve coped or what they’ve found useful and to feel connected with others.

4-5 stars review

You Life’s Quality

The overall quality of life can significantly diminish when chronic pain is a constant companion. Simple tasks become monumental challenges. If you think of your day as a set of scales: on one side is the pain and how you may be feeling which could be quite a heavy weight. On the other is all the things you can do to feel like you’re gaining control again. Life can be all about the small wins such as getting out of bed and washed, eating a meal that isn’t only made up of beige ingredients, drinking plenty of water, turning off the TV and speaking with one person today… they can all be small weights to put on the scales opposite the pain to help you feel you’re winning back control.

Self care, self love, small wins

The Way Forward?

There is so much more to chronic pain than could ever be written in a blog post. We haven’t even mentioned looking at aspects such as asking your GP for a medication review (many pain-relieving medications are limited in their usefulness with chronic pain), or looking at lifestyle changes (less beige foods and more moving about – in an ideal world, outside).

To stand a chance in effectively managing and alleviating chronic pain, you’ll probably need to address the body and the brain. It’s not a quick fix so you’ll need to develop skills in patience and resilience, but taking a holistic approach (rather than focusing on only one type of treatment), and having a little support, you can absolutely do this.

Thank you for checking in and take care,

Lisa 🙂