This year has been a difficult and challenging one. For the past year and a half, I have been navigating chronic back pain. I saw countless doctors, did physical therapy, received injections and tried various medications. My quality of life was fragile and heavily dependent on my level of pain and ability to function. Last December I went into surgery, which was a very scary and difficult decision.
Living with chronic pain and ultimately deciding to have surgery pushed me to expand my knowledge, examine my thinking, and learn more about my body and the powerful connection between mind and body.
Through studying experts in the field of pain, I learned that pain is far more complex than a simple process of cause and effect. I gained a deeper understanding of how our brain, emotions and physical damage communicate and work together to create our experience of pain.
While acute pain is an essential survival mechanism, an alarm system warning us of physical damage (like a broken bone), chronic pain behaves differently. Chronic pain is no longer just a sign of ongoing tissue damage; it is evidence that the brain’s alarm system is stuck in the “on” position.
From a psychological perspective, chronic pain feeds on a vicious cycle. When we experience ongoing pain, the brain interprets it as an existential threat. This perception activates the sympathetic nervous system commonly known as the “fight-or-flight” response.
When this system remains activated over a long period of time, the body stays in a state of constant tension, cortisol levels rise, and the brain becomes increasingly sensitive to pain signals, a process known as central sensitization. Catastrophic thoughts like “I will never get better” or “my body is broken” are not just consequences of the pain; they can become the fuel that keeps the alarm activated.
Managing chronic pain requires an integrative approach that recognizes the close link between the mind and body. I wanted to share with you some effective coping strategies you can try which can promote healing through neuroplasticity (the brain’s ability to rewire itself) and help reshape the brain’s pain pathways:
Mindfulness and Meditation: Practicing mindfulness helps alter how the brain perceives pain signals. Instead of fighting the pain, one learns to observe it without judgment, reducing the accompanying physical and emotional tension.
Deep Diaphragmatic Breathing: Slow, deep breathing activates the parasympathetic nervous system (the relaxation response), lowers cortisol levels, and helps relax clenched muscles.
Body Scan: A technique that involves moving attention through different parts of the body. It helps identify areas of tension, consciously release them, and restores a sense of control over the body.
Pain and Emotion Journaling: Writing intuitively about emotions, frustrations, or daily experiences can reveal direct links between emotional states (like stress or anger) and pain flare-ups.
Graded Activity: People with chronic pain often avoid movement out of fear (kinesiophobia). Gradually reintroduce small, enjoyable activities while sending messages of safety and pleasure to your brain, breaking the automatic link between movement and pain.
As I continue to recover from surgery, I am learning that even though the structural damage has been addressed, my pain and anxiety still require attention, care and healing.
Today my body and I continue to renegotiate the contract between us. I have learned to listen to my body better, to expand my curiosity and examine feelings of doubt, to demand and seek more information. I am learning how to trust my body again and to overcome avoidance behaviors that fear can create.
If you are living with pain, give yourself the gift of curiosity and compassion as you navigate through this journey to find the answers and treatments that are right for you.
Nofar Gal , M.S., MBA
Licensed Professional Counselor