Pain and Thoughts

Key learnings:

  • How chronic pain affects our cognitive abilities, memories and emotions
  • Learn about the negative affects persistent pain can have on our mental health
  • Healthy thinking techniques to cope with chronic pain

Chronic Pain’s Effect on the Brain

Central sensitisation

The nervous system of a person with chronic pain is often in a state of high reactivity, therefore producing pain that is amplified. This condition is referred to as central sensitisation. This means something as simple as a light touch, massage or bump could cause the brain and nervous system to go into overdrive, producing a sensation of pain and discomfort. Pain can also be felt without movement and by thoughts alone.

In people with persistent pain, central sensitisation can also cause the pain ‘memories’ to persist long after the original cause of the pain has healed. This explains why people with chronic pain can experience pain, despite their x-ray or scan appearing normal, or why amputees feel phantom pain. In some instances, patients may experience both fear and pain with a certain movement, as a result of the memory of the original injury or event that caused the pain becoming intertwined.

Learning about pain management can help to retrain the brain and reduce the strength of pain signals being sent to the problem area.

Hear from Dino Urzi – Clinical Psychologist

  • Pain can affect the way we feel. The way we feel can affect pain. How is this possible?
  • What can we do to manage how we feel and see pain so we can change our experience of pain? For example:
    • CBT – cognitive behavioural therapy
    • Mindfulness
    • ACT – acceptance, commitment therapy

Mental health

One in five Australian adults with severe or very severe pain also suffer with depression or other mood disorders.


Even small and insignificant things can be a big deal when you live with chronic pain.

Chronic pains effect on the brain can impact the way we feel. It can leave us feeling lonely, upset, angry and frustrated. As shown in the diagram below, chronic pain leads to reduced gray matter in the brain, which can impair cognitive abilities (ability to process thoughts), memory and lead to emotional problems. The way we feel can affect our thoughts, which can negatively affect our experience with pain. As such, it is important to have a positive mindset, which can support you to feel more energised and encourage you to take steps towards feeling better.



Some contributing factors that encourage or exacerbate persistent pain are:

Stress and allied factors

Stress can alter the balance of our system by switching on the nervous system, hormones or immune response, forcing our body to work extra hard to return to its original state. This can bring about a wide range of physical and emotional reactions, which can increase pain both in the short and long term. Stress can also affect the way we think and behave. Changes in eating and sleeping habits, lack of motivation, neglect, isolation or taking up smoking to cope are a few of the behaviour changes that can result from the pressure of stress and impact how long persistent pain lasts.

Your surroundings

Our surroundings can have a role to play in how pain is experienced. Family challenges and conflicts reduce resilience to pain. This also applies in the workplace. Poor work satisfaction, physical discomfort at work and poor peer support can result in increased pain.

Experiences from the past

Experiences from the past may impact the way chronic pain is felt and handled. Early identification of negative past experiences of pain assists in managing the risk of developing persistent pain.


Pain and depression are conditions that are commonly linked. Those suffering from pain have a 30% to 40% greater chance of developing depression. Likewise, people with persistent pain can develop problems with anxiety. In some cases, an underlying medical problem such as fibromyalgia can give rise to both pain and depression. Seeking help to manage emotional and mental health is a significant part of reducing chronic pain.

Techniques for Managing Thoughts and Feelings

Practice healthy thinking

In chronic pain, it is important to be conscious of your thinking so you can choose your thoughts and language more mindfully. If you choose to actively practice techniques like mindfulness, you will be less likely to:

  • Magnify the threat of your pain
  • Get stuck thinking continuously about your pain
  • Feel helpless about your ability to cope with pain

A range of techniques are available to help develop healthy thinking habits to support you in managing your pain. Below are some tips to get you started:

  • Find things that you feel able to do and that you enjoy. For example, give a friend a call once a day, who will encourage and listen to you. It is important to stay connected.
  • Give yourself a ‘pat on the back’ and reward yourself for the good things that you do. Celebrate even the smallest efforts.
  • Regularly schedule in something nice for yourself.
  • Practice relaxation techniques, breathing techniques, positive affirmations and keep focused on what you can do or try next.

Another technique to develop healthy thinking habits is to tune into your own thoughts. This can be achieved by completing the below 3 steps.

  1. Notice your thoughts. When you notice a negative thought, stop it in its tracks and write it down.
  2. Look at that thought and ask yourself whether it is helpful or unhelpful.
  3. Choose a new, helpful thought to replace a negative one. Ask yourself: What effect does believing this thought have on me? What might happen if I tried to believe the healthier thought?

Being intentional about trying and doing things that make you feel good will help you take the next positive steps in managing your chronic pain.

How your pharmacist can assist with pain, thoughts and feelings

Pharmacists have an important role in helping you manage your medication related problems when dealing with chronic pain. This includes giving you the confidence to self-manage your pain by providing management options to help you focus on thoughts when dealing with chronic pain, so you feel in control of your pain. Pharmacist can provide a Medication check with a pain focus to help identify areas where you need support or assistance and can help you work through this plan. Below is a list of other ways your pharmacist can support you.

  • Recommend natural remedies
  • Provide referrals to allied health professionals
  • Recommend helpful apps or websites to support you to practice relaxation techniques and breathing techniques
  • Keep you focused on what you can do or try next
  • Recommend local support groups for you

Support resources

Looking for support to cope with chronic pain and thoughts? Visit the below pages for relaxation and healthy thinking techniques that can be applied at home.

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