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Fear and pain

Have you ever had these thoughts when you experience pain?

  • Jumping to conclusions: "I will never be able to do (activity of choice) again."

  • Jumping to assumptions or beliefs: "Well, this is what happens when I get older. There will probably be more to come." or "I deserve for this to happen."

  • Jumping to past experience as being the ultimate truth: "This is just like the pain my mother had and she became completely debilitated."

  • Jumping to worst case scenarios: "Something is broken or damaged." or "Maybe this is cancer." or "Maybe this is M.S."


There is nothing particularly wrong with these thoughts. In fact, they are the normal human experience. Think about it, if we NEVER had fear, we might have been dead by now. Our brains are primed for survival so when we experience pain, our first reaction might be to panic. When we panic, where do we often turn? Paging Dr. Google, Dr. WedMD, and forums of other folks that have similar experiences. Now, these pages have their purpose. There can be some useful information. But the totality of information that Google and WebMD try to cover can be quite alarming and most of the time completely unrelated to your scenario. Forums are similar in that they provide great ideas at times but at other times may actually be sharing false information. Remember, no one is fact checking forums. What would the best resource? Your healthcare team; people that are experts in their field. Second (or even more) opinions may also be appropriate.


In fact, fear and pain is SO common that in the PT world, they have developed a survey to measure it called the Fear Avoidance Belief Questionnaire (FABQ). This helps the practitioner understand how much fear may be playing a roll in the lack of progress that is observed in the clinic. It is a well-researched questionnaire that has been shown to be correlated with level of disability and pain intensity. The example here is for back pain but it can be applied to pain anywhere in the body. If you take this questionnaire for yourself and notice you score high for many of the statements, it would behoove you to dive deeper by talking about it with a professional.


This diagram below is a great visual for the fear/pain process:



https://www.jospt.org/doi/10.2519/jospt.2017.7434?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed



In regards to worst case scenarios, there still is a possibility for them to happen. Those are easily found on the internet or from your gossiping neighbor. I do not want to discredit them because although the percentage is small, there are still people in this world that find themselves in that predicament. If this is truly a concern, turn to healthcare professionals who can give you factual information and run tests if they are warranted. Also connect with a counselor, psychologist, or psychiatrist so that you have support to navigate it all, no matter the diagnosis.


Remember, pain is very complicated (check out previous blog posts!). The stimulus that is "registered" as pain is received and processed in the brain. The brain is certainly not a blank slate. We approach life looking through a lens that includes our attitudes, our experiences, our beliefs, our fears, etc. Welcome your fear when it happens. Acknowledge it and talk about it with people you trust. Get credible information from healthcare providers. Remember that you are not alone.

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