How to Break the Pain Cycle of Persistent Injuries

There are two types of pain, says David Schechter, M.D., the author of Think Away Your Pain. There are the acute and subacute kinds: You sprain your ankle, you treat it with pain meds or physical therapy, and it goes away within a few months. Then there’s the type that persists.

“Functional MRIs show that chronic pain originates in a different area of the brain from acute pain,” says Dr. Schechter. It activates the amygdala and prefrontal cortex, two areas involved with emotional processing. “It’s real pain,” he says, but medication and physical therapy can’t completely cure it. “You have to heal the altered pathways in the brain too.”

Here are the best science-backed ways to manage pain with your mind.

Believe it.

The first step is realizing that your pain is coming from those obsolete nerve pathways, not an ongoing problem in the area that hurts. You can confirm that your injury has healed by getting an exam and, if necessary, imaging from a doctor.

But it can be hard to let go of the idea that something is wrong physically. Keep reminding yourself: The pain is coming from a misdirected route in your brain, not your body.

Don't let it stop you.

In an effort to manage pain, people with chronic pain often avoid activities, like running and biking, that they fear might trigger symptoms. But this can make the problem worse.

“The more you focus on, anticipate, and worry about pain, the more pronounced the pathways in the brain that are causing it become,” says Dr. Schechter. Your mind starts to perceive normal actions, like going for a walk, as dangerous, creating even more pain to get you to skip them.

To help the brain unlearn this fear, reintroduce the activities you’ve been avoiding. Gradually start jogging or biking for longer time periods. And consider cutting back on techniques you’ve been relying on to ease your pain: Dr. Schechter says some people benefit from stopping things like physical treatments or using a brace, which may also encourage you to focus on your pain.

Write it out.

Stress and tension can make the pathways that cause chronic pain more sensitive. That may be why research shows that stress worsens chronic pain conditions.

To keep it under control, Dr. Schechter recommends journaling for 10 to 15 minutes a day about what’s causing you stress and anger, as well as what’s making you feel happy and grateful. This kind of outlet alleviates negative feelings and encourages positive ones, which helps diminish pain.

You can also use an app like Curable (from $8 a month), which provides information and writing exercises designed to help stop chronic pain.