BONUS SERIES: PRT: Part 3 - Why Fear Can Keep Pain Going

Now when I say fear, I want to be very clear about what I mean.

I'm not saying that you caused your pain because you're anxious.

I'm not saying the pain is imaginary.

And I'm definitely not saying just stop being afraid and you'll feel better.

What I'm talking about is what can happen after pain has been around for a while.

Because eventually we can start becoming afraid of the pain itself.

And sometimes without realizing it, we become afraid of anything we think might trigger it.

Maybe you had back pain for months.

One day you bend down to pick something up and you feel that familiar sensation.

I see it all the time with patients.

And before you even have time to think about it, your brain goes, Oh no, God no.

There it is.

I did it again.

I did something.

I shouldn't have bent over like that.

Did I just make it worse when I did that? What if this flares up for the next three days? Those thoughts happen so fast, and we often think of them as just thoughts.

But to the brain, those thoughts have meaning.

And if your thought is, something is wrong with my body, your brain hears, danger, danger.

If your thought is, I need to be really careful, your brain hears, danger, danger.

If your thought is, this movement could hurt me, your brain only hears, danger.

And remember what pain is designed to do.

Pain is protective.

So when the brain believes there is danger, it may turn up the protection.

This can look like more muscle tension, more guarding, more scanning, more sensitivity.

And now the association becomes even stronger.