Week 1: Understanding chronic pain

Week 4: Healthy thinking, healthy self

Week 5: Balancing your activity patterns

Week 6: Maintaining your gains and staying well

Stress and worry in chronic pain

As we mentioned, having chronic pain is a major stressor with flow on effects in all aspects of life. People with chronic pain often worry about their situation, which can worsen their pain and keep them stuck. Worry itself is a very demanding activity, which takes up a lot of time and mental energy. Worrying involves thinking about or dwelling on a certain situation or concern, over and over again. If your worry is frequent and hard to control then it may be a problem.

You can identify worry by the following features:

  1. You anticipate something negative will happen in the future, and
  2. You have the same thoughts about this over and over again

Prolonged or frequent worry can generate anxiety and create further worries. This keeps the fight or flight response activated and maintains symptoms of anxiety. Worry itself is fatiguing and can cause or exacerbate pain through muscle tension. It can also cause symptoms like headaches, nausea, and so on. Worry often prevents helpful thoughts and actions, and leaves people less able to deal with stressful situations effectively. Negative consequences often occur, adding even more stress and creating new problems to worry about. 

For example, Juan suffers from severe chronic pain. Due to his pain, Juan has missed several classes recently and is worried he won’t pass his end of year exams. Juan’s worry about university triggers a negative cycle. Here’s how Juan’s worries snowballed:

  • Juan worried about the impact of his chronic pain on his ability to attend classes
  • Juan worried about whether he would pass his exams and maintain his high grades
  • Juan fell further behind at university and started worrying about failing his degree altogether
  • Juan’s parents became concerned and over involved, which added further pressure for Juan
  • Juan felt like he had to manage his parents worry, as well as his own
  • As a result of the stress, Juan’s relationship with his girlfriend became strained. He started worrying about this too.
  • Worrying about his parents and his relationship meant Juan was even less able to focus on his studies. His grades slipped further and his fears about not completing his course became even more real.

You can see how unhelpful worrying was for Juan. A single worry turned into a series of other worries. Psychologists sometimes refer to this snowballing effect or series of worrisome thoughts as a ‘worry chain’. Worrying is very different to problem solving. Worrying is a negative thought process which involves dwelling on the worst case scenario; it just leaves us anxious and unprepared for what’s to come. Problem solving, on the other hand, involves taking steps to find a solution and deal with the problem.

As mentioned, chronic pain and worry often go hand in hand. Common worries associated with chronic pain including things like:

  • “What if I injure myself more?”
  • “What if I can’t keep up with the others?”
  • “What if I can’t move after this?”
  • “What will I tell my employer?”
  • “How will I cope with being on my feet for that long?”
  • “This pain is too much for me”
  • “I don’t know how to socialise anymore, it’s been too long” 
  • “What if my pain gets the better of me?”

Do you identify with any of these worries? Take a moment to think about your own worries. Do you have worries about the future or how you’ll cope in certain situations? These types of worries commonly trigger feelings of anxiety, which sets off the body’s stress response. Many people with chronic pain find that their symptoms get worse when they are stressed or worried. As such, it is important to learn ways to reduce stress and worry.