The Psychology Of Pain

There’s no point in sugar-coating it: chronic pain is distracting and exhausting. It’s very common for people experiencing a chronic pain condition like arthritis to feel isolated, angry and/or depressed. 

“Pain has a massive effect on someone psychologically because pain directly impacts your experience of the world and everyday activities,” says Katelyn Kivett, an Eye Movement Desensitization and Reprocessing (EMDR) trained therapist who specialises in working with complex trauma and chronic pain. “Remaining optimistic is incredibly difficult when you’re in pain because that pain can be due to simple things like showering, putting away groceries or getting ready for the day. It can also be difficult to need assistance for these daily tasks and feel that you cannot maintain independence or autonomy.”

How you feel psychologically is just as important as how you feel physically -  and the two are very closely entwined. By acknowledging and

overcoming the psychological components of pain, you can improve your quality of life and lessen the physical symptoms.

How can you stop the pain of osteoarthritis taking over your life?

Being in pain has a profound impact on your experience. Chronic, long-term pain can lead to brain fog, anxiety, stress, depression, distraction and anger. It can be hard to stay present and regulated around people - especially if it doesn’t feel like they understand what you’re going through. Osteoarthritis is also unpredictable and doesn’t follow a neat schedule, so you may have days where you feel okay and then the pain sets in at an inconvenient time - which can lead to further frustration, stress and the feeling that you’re not in control of your life.

Learning ways to cope emotionally, practice mindfulness and find new ways to relate to your pain can be really helpful. Mindfulness can help reduce inflammation, relax tense muscles and boost your mood, which can all help alleviate pain. Mindfulness can also help you learn to experience physical sensations without putting a label on them, which can make them easier to deal with. It can help you see the changing nature of your feelings, both mental and physical, which can help combat all or nothing thinking. A quick and easy way to practise mindfulness could look like sitting somewhere quiet, closing your eyes and becoming aware of your thoughts, feelings and physical sensations - rather than getting caught up in them, you acknowledge them and let them go. Vipassana meditation (sometimes called insight meditation) can give you a step by step practice to enable you to experience physical and mental sensations with mindful, calm awareness.  You may also want to try guided imagery, which is thought to significantly reduce musculoskeletal pain, and mind-body exercise practises like Tai Chi and Yoga. 

You may also find therapy helpful and there are options available on the NHS and privately. “The first learning curve with chronic pain is learning how to effectively communicate,” says registered counsellor Sumarie Engelbrecht. “Finding ways to cope and express your feelings is crucial not only for yourself, but for those around you as well. Mindfulness-Based Stress Reduction (MBSR) and Acceptance and Commitment Therapy (ACT) are two effective methods to get in touch with how you are feeling. Once you know how you are feeling, you will be able to communicate those feelings better to those around you. ACT also encourages you to get to a place where you make peace with the chronic pain and commit to activities that give your life meaning, helping you find joy despite the pain.”

How can you deal with the alienating aspects of living with an invisible health condition?

Being seen, heard and understood is an important experience that everyone deserves to have. “Humans are social creatures and the feeling of isolation and ‘no one understands what I am going through’ is one of the most detrimental thoughts for mental health,”  says Sumarie Engelbrecht.  “That's why building a community is vital. Support groups, whether in-person or through online forums like Reddit, can help you feel less alone. Sharing your experiences with others who understand can provide immense comfort and validation.”

Having to constantly explain how you’re feeling can be draining, but there are ways you can make the process easier for everyone involved. 

“The invisibility of many chronic pain conditions adds another layer of complexity, often making it challenging to communicate one's experience to others,” says Mona Kirstein, a holistic health & wellness coach. “To address this, I encourage clients to develop a ‘pain vocabulary’ using relatable metaphors. For instance, one client describes her pain as ‘a grumpy houseguest’ - it's there, but it doesn't run the household. Another uses weather analogies, like ‘Today is a cloudy day’ versus ‘It's a full-blown thunderstorm’. These metaphors help loved ones understand varying pain levels without requiring detailed explanations each time.” 

Another option for a quick way of explaining how you feel is using a scale of 1 to 10, with 1 being minimal pain and 10 being the worst pain imaginable. Not only can this help you explain how you feel to your loved ones, but it can be very helpful when communicating with your doctor. Different people experience pain differently, so being able to explain it in this way can help others better understand how you’re feeling. 

You may find joining a support group or a forum specifically for people living with osteoarthritis helpful, as you will then be able to share your experiences with people who truly understand. There are also hotlines for people living with arthritis which can be helpful when you want to vent and be heard by someone you don’t know. Resonating with other people's experiences can also be really helpful when you’re feeling alone, and there are many testimonials and real life stories available to read and watch online.

How can you adapt the activities you love so you can still do them within your limits?

Doing activities when you have arthritis can be difficult and stressful, especially when it feels so much harder to do something that used to be second nature. It is important to listen to your body and make modifications when necessary, but you shouldn’t have to give up doing something you love - you just might have to be creative in how you do it.  

“Adapting daily routines is crucial; modifying beloved activities can allow individuals to remain active without overexertion,” says Kristie Tse. “Engaging with nature or participating in low-impact exercises can be fulfilling while accommodating physical limitations. Acceptance of this new normal is paramount, as it opens doors to joy and meaningful connections. The journey involves balancing personal passions with self-care, fostering a resilient mindset.”

If you love running because it gets you out of the house and clears your mind, why not try going for a walk and see how that feels? If hot yoga is your thing and that feels unachievable, then there are many other types of yoga which may be friendlier to your body and still have heaps of health benefits. If you struggle walking, why not try getting in the pool and moving around in that environment? It’s really important to keep exercising when you have arthritis because doing so strengthens the muscles around your joints, improves circulation, releases endorphins and can have a massive positive impact on your quality of life. It might not look quite how it used to, but it can still be incredibly rewarding and beneficial.

It’s also important to celebrate the small wins, rather than focusing on limitations.  “Break down tasks into manageable steps and celebrate small victories,” says Sumarie Engelbrecht. “This can help you maintain a sense of accomplishment and control.”

Tips on how to manage the psychological effects of pain

Keeping a pain diary may not sound like the most fun activity, but it can help you start to see patterns which can help you manage your condition better. It doesn’t have to be time consuming - you can simply write the time of day and rate your pain from 1-10, and there are also apps available. This can be really helpful when you’re doing physical activity, so you can start to break down how you feel when you’re doing specific things and adjust accordingly.  

“Living with a long-term pain condition like arthritis can profoundly influence your identity and interactions with the world,” says Kristie Tse. “Pain can overshadow joy, cause withdrawal from social engagements, and foster feelings of isolation. It is essential to acknowledge these impacts rather than dismiss them. Journaling is a powerful tool; it allows for reflection and provides a healthy outlet for expressing emotions. I encourage my clients to articulate their pain not just physically but emotionally, offering a richer context to their experiences. Identifying coping mechanisms, like mindful breathing exercises or gentle movement practices, can empower individuals to reclaim their sense of agency. It’s vital to cultivate a support network—friends, family, or support groups can provide understanding and validation. Embracing these strategies can lead to a more balanced perspective, allowing pain to exist without defining your entire being.”

Chronic pain can create a vicious cycle of stress, where the pain causes more stress and the stress in turn causes inflammation, tight muscles and emotional discomfort which can make the experience of pain worse. “The biggest thing to remember is that your brain is one of your most powerful tools for pain relief,” says Katelyn Kivett. “If we can soothe the nervous system and calm our body’s reaction to chronic pain we can decrease the overall pain. This may look like engaging in relaxation exercises, biofeedback, EMDR therapy or progressive muscle relaxation.”

Living with pain is a lot and it’s okay to accept that it’s a lot. We don’t want to tell you to just ‘think positively’ and it will all go away, because that’s just untrue. What is true, however, is that there are things you can do to change how you relate to your pain - and that can reduce the physical as well as emotional discomfort that comes with it.

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