How to reduce pain by improving the brain-body connection

Imagine for a minute that pain isn't something that happens TO you, but instead, it's more like a conversation that happens between your brain and your body.

Now imagine you had the skills to improve that conversation from an angry shouting match to a more respectful discussion. By the end of this article, that's exactly where you'll be.

Using Pain Neuroscience Education as an approach to pain management shifts the focus from solely treating pain symptoms to using knowledge about how pain works. You’ll be empowered to take an active role in your pain management. By better understanding your body’s response to pain, you can minimize your experience of pain over the long term.

Understanding the body's burnout alarm system

Let’s say you grabbed something hot by accident. Would you want to know about it? Of course you would. You’d want to let go of the object, and get the burn treated if necessary.

But how does your body know it’s touched something hot and needs to let go? The nerves throughout your body actually act as a pretty sophisticated alarm system. Think of nerves as your body's electrical wiring—they transmit signals between your brain and your body. Every nerve has a little electricity; normally, they’re just buzzing along, fluctuating up and down throughout the day. But there is also a threshold built into your alarm system. When the nerve signals accumulate and cross that threshold, your alarm system activates.

What happens when you burnout?

So, for example, when you burn yourself, your alarm goes off. In response, the brain will send signals to correct the situation and move your hand. If you pull your hand away, the alarm slowly turns down over time—that is, if the alarm system is operating normally.

Sometimes, the system will stay activated, which means your nerves remain closer to that threshold. When this happens, you’re more sensitive to other stimuli because it takes smaller infractions for the nerves to cross the threshold and sound the alarm.

There are a lot of reasons your system might remain sensitive. External factors such as stress, anxiety, lack of sleep, negative beliefs, past trauma, or feeling out of control of your pain can all influence the sensitivity of the nervous system.

So, how do you reset your alarm system back to baseline?

Unfortunately, there is no magic reset button. It is important to know that you do have control. By understanding the alarm system and the external factors that influence it, you can improve the conversation between your brain and your body.

Keep reading to uncover tools that can help you transform your pain experience and regain a sense of control.

Reducing pain through stress management

When stressors accumulate, they act as triggers that activate the body's alarm system, making it more sensitive. And when an alarm system is sensitive, it fires pretty easily. By reducing stressors, you can turn down the sensitivity over time, helping to prevent constant alarm activation—which results in a reduced pain experience.

Working with a mental health professional can be a helpful way to combat stress. But there are also simple lifestyle changes you can make to minimize its presence in your life. For example, the following simple adjustments have all been shown to help reduce stress and anxiety:

• Eating healthily
• Spending time with friends and family
• Organizing your time and prioritizing tasks
• Laughing more

Understanding how your stress and pain develops

Take a moment to reflect on experiences in your life that amplify your feelings of stress. Then think of ways you can modify your behaviors to minimize exposure to that source.

For example, is your morning commute a regular source of stress? What happens if you leave earlier to avoid traffic? Or try taking the bus or carpooling?

Additionally, there are techniques you can try in the moment when you are experiencing a heightened state of anxiety.

How to use box breathing to reduce stress

For instance, box breathing is a simple technique that can help calm the mind and body during times of stress. Here’s how:

• Breathe in, counting to 4 slowly. Feel the air enter your lungs.
• Hold your breath for 4 seconds.
• Slowly exhale through your mouth for 4 seconds.
• Hold for 4 seconds.
• Repeat these steps until you feel re-centered.

How to use body scanning to reduce stress

You can also try a body scan, a relaxation technique that counteracts the physiological effects of stress. It promotes a sense of calm while serving as an antidote to painful sensations. Here’s how you do it:

• Sit or lie down in a relaxed position.
• With your eyes closed, start at the top of your head and mentally “scan” down your body: Bring your awareness to your head and neck, and notice if you feel any feelings, sensations, or discomfort.
• Ask yourself, “Does that area feel relaxed or tense? Comfortable or uncomfortable? Energetic or tired?”
• Repeat this practice for your shoulders, arms, hands, chest, back, hips, legs, feet, and so on—taking about 20-30 seconds to focus on each body part.

When you encounter areas of tension during the scan, don’t struggle. Instead, focus your attention on them and breathe. Try to visualize the tension leaving your body. Don’t try to change anything—you are simply building a picture of how the body feels right now, in the moment.

Minimizing pain by improving your sleep

Another powerful tool for turning down the sensitivity of your alarm system is getting better sleep. Research shows that short sleep times, fragmented sleep, and poor sleep quality often cause heightened sensitivity to pain. In fact, even subtle changes in nightly sleep — reductions that many of us think little of, in terms of consequences—have a clear impact on your next-day pain burden.

When your body and mind are well-rested, on the other hand, you're better equipped to cope with pain triggers and stressors. Now you might be thinking, that makes sense, but what if my pain is the very thing preventing me from getting sleep? When pain makes it difficult to fall or stay asleep, all of this can start to feel like a never-ending cycle.

How to improve the quality of your sleep

While it may seem impossible now, there are things you can do to improve the quality of your sleep with practice and consistency. Try incorporating some simple desensitization exercises as part of your bedtime routine to calm the nervous system and help prepare your body and mind for rest.

Start with some simple shoulder rolls while seated on the edge of the bed:

• Squeeze the shoulders up toward the ears, and then roll the shoulder blades down toward the back.
• Repeat this 5 or 6 times, rolling into every corner of your shoulders. Then change direction.

Another calming movement is a trunk rotation:

• Transition from a seated position and lie down on your bed.
• Lying on your back with your knees bent in the air and feet flat on the bed, slowly begin to drop your knees toward one side of the body. As you lower your knees, your trunk will also begin to rotate to the same side. But keep your upper body in contact with the bed.
• Once the knees have dropped enough so that one side of the pelvis is elevated off the bed, hold to feel a stretch through your hips, side, and back.
• Then, return to the starting position and repeat the movement on the other side of the body.

Ideally, you’d repeat this exercise a few times on each side, but do what feels most comfortable as you begin to feel sleepy.

You can also add the relaxation techniques discussed in the previous section. Both box breathing and a body scan will help if you add these to your nighttime routine. Your body can relax further and divert focus from your pain.

In addition to this relaxing bedtime ritual, look for ways to improve your sleep hygiene with things like setting a consistent bedtime and optimizing your environment for restful sleep. Sword members can learn more about specific ways to do this in our Academy series on Sleeping. Academy is available to active Sword members via the mobile app for iOS and Android.

Remember that sleep hygiene practices are cumulative, so consistency over time is key to reaping the benefits of improved sleep on pain management.

Using graded exposure to get back to movement

Pain can make it tempting to avoid movement but movement truly is the best medicine. It’s one of the greatest treatments and preventative measures for pain.

Now, you might say, “I know I should move, but it hurts.” This is a normal protective mechanism. However, over time, opting out of movement due to potential pain becomes a subconscious behavior called fear avoidance. It can contribute to a cycle of increased pain perception, reduced physical function, and decreased quality of life.

The good news is, you can confidently conquer your fear avoidance. Start by naming specific movements, activities, or situations that trigger fear or anxiety due to the anticipation of pain. These are different for everyone. Some examples may be running, bending over to tie your shoe, or picking up your toddler.

Once you know what you’ve been avoiding, you can use graded exposure to regain confidence in those movements. Graded exposure is a technique used in pain management and rehabilitation that gradually exposes people to the movements or activities they've been avoiding, using a controlled and systematic approach.

Think of it like making microwave popcorn. Each microwave and brand of popcorn always pops a little differently. So, to avoid burnt popcorn, you start by setting your microwave for a minute or two—a short time you know won’t burn it. Then, you stop and check it. Maybe you add 20 seconds. Stop. Check again. You keep going until you have popped the majority of the popcorn kernels, but haven't burned the whole bag.

Returning to movement with pain is the same concept. Similar to the initial minute or two of microwave time, you choose a set period of ramp-up time that you know you can do without increasing your pain. Then, decide what your equivalent of the 20 seconds of additional microwave time will be (based on the movement you’re returning to)—after which you will stop and check in with yourself and your pain before deciding whether to continue. This concept is known as pacing.

The goal is to reduce fear and anxiety while promoting a sense of safety and confidence in performing those movements. All of this helps the nervous system become desensitized to the movement it previously feared. You can work with your physical therapist or healthcare provider to develop a graded exposure plan specific to your situation.

Weathering setbacks and cultivating a positive mindset

It’s important to remember that desensitizing your alarm system takes time, and managing your pain is a journey—one that will have its ups and downs. You will likely encounter setbacks during your recovery.

A setback is when you start to experience an unexpected worsening of symptoms or a disruption in progress toward your goals. And the truth is, it’s extremely common. A setback can result from overexertion, changes in activity level, stress, illness, or even as just a natural fluctuation in the course of chronic conditions.

To overcome a setback, maintain perspective. Having a long-term view on recovery helps the bumps along the way feel less jarring. Set some short-term goals to help build your confidence again! And remember: Setbacks are temporary. You are not back at square one.

Stay curious about what might be triggering your setback. Triggers could be physical or emotional, and include a wide range of things from having the flu to experiencing a loss in the family. Understanding the ‘why’ behind your triggers can help reduce their recurrence in the future.

Resilience is your greatest ally on this journey. Some of your previous go-to strategies may stop working as your body adapts. When this happens, try to find new alternatives that can offer relief as you work back to your previous level of progress.

Finally, be kind to yourself. Treat yourself with the same compassion you'd give to a friend in distress. If a loved one shared their struggles with you, you'd likely respond with patience and comfort. Yet, many of us don't extend the same kindness to ourselves. Make it a daily practice to offer yourself the understanding you'd give to others.

Kindness, compassion, and a positive mindset will all help you throughout this journey. But they’re particularly helpful when you’re experiencing a setback. Of course, pain can make it difficult to feel positive. But with practice, you can build a positive mindset over time.

How to create a positive mindset and overcome pain

To cultivate a positive mindset, try using an exercise called Three Good Things:

• Grab some paper and something to write with.
• When you are ready, reflect on the day's events for a few moments. Think about the good things that happened. What are you grateful for? They don’t have to be big things like a job promotion or winning a lottery. They can be simple—like getting outside for a walk with a friend or making your favorite meal.
• Write down three good things that happened today.

Studies have shown this type of reflection to have a positive impact on your well-being when done consistently. So try to make this a habit by setting a daily notification or working it into your bedtime routine.

Remember, you have the power to shape your journey of recovery. With patience and resilience, you can navigate the challenges and emerge stronger and more empowered. This is an investment in your future well-being and quality of life.

Do you want expert support—from Doctors of Physical Therapy, on-call pain specialists, personal trainers, and more—as you navigate your pain journey? Check if you're eligible to become a Sword member through your employer or health plan.