How Your Thought Process Can Influence Your MSK Health

Date:  May 18, 2016


How Your Thought Process Can Influence Your MSK Health

iStock_000070436615_web“Fear of pain was more disabling than the pain itself”1

Your body instinctively tries to avoid pain, and it is inherently built to sense it, interpret it, and guard against it. This function is an important protective mechanism that allows us to identify danger or injury and protect ourselves from further damage. When a painful stimuli is felt a signal is sent to the spine and then to the brain to interpret the information. Luckily, the body can react quickly to avoid further harm.

Beyond the physical sensation of pain, there is another factor that has a powerful impact on the body—how we think about or perceive pain can affect the body’s healing and recovery process. This is certainly the case with musculoskeletal (MSK)-related pain. In fact, our cognitive processes can positively or negatively affect how we recover. It has been suggested that certain beliefs and attitudes about pain can increase your likelihood of chronicity and disability and delay recovery.

Here are some of the potential cognitive barriers to your recovery:

Beliefs and Attitudes2,3

When you are in pain, it is natural to think about it and adjust your behaviour to adapt. For most people, the body quickly identifies a painful stimuli and reacts to avoid further harm—which is why you pull your hand back when you have touched something hot, or lift your foot off the ground when you have stubbed your toe. Your body also automatically starts the healing of tissue as soon as an injury has occurred.

Yet at times we can have certain beliefs about pain that end up hindering our recovery. For example, believing that pain is harmful or disabling may lead to avoiding activity and movement (thus trying to protect oneself), or unnecessarily guarding the area of injury. Also, “catastrophizing” or thinking the worst about your symptoms can exacerbate them, both psychologically and physiologically. Believing that you have no control over the pain and recovery process can become a significant barrier to getting better and resuming daily activities.


We all hope for a quick recovery from MSK pain, or any pain. Having unrealistic expectations about the time needed to recover can have a negative impact on one’s psychological well-being, which can have direct consequences on how your body recovers. In other words, by under-estimating the expected time of recovery, you are doing your body more harm than good. So, keep in mind that, depending on the nature of the injury, the time needed to regain function or alleviate symptoms may take longer than expected. Be patient as you heal and improve.


We all typically experience an emotional reaction to pain. Common emotions include fear, anger, guilt, frustration, and even depression. For example, fear of pain with activity can delay recovery and return to work, because you are holding back in the physical aspects that would help you restore mobility and return you to activity. Similarly, some may feel stress or less of a sense of control.

Interestingly, even though the relationship is not yet well understood, depression (or a persistent, long-term low mood) is one of the strongest predictors of chronic pain—the type of pain associated with an MSK injury.

There is no doubt that suffering an injury and pain can be an overwhelming experience, but employing different coping strategies can certainly help you in your recovery. There are a number of possible techniques and treatments available to assist in managing pain through addressing emotional and psychological factors. These treatment options include meditation, mastery of mind, biofeedback and cognitive behavioural therapy, to name just a few.

Speak with your chiropractor to learn ways to better manage your MSK conditions to ensure proper healing and recovery, and speak with a mental health professional to assist with any psychological aspects that you feel may be impacting your physical pain or limiting your recovery.


1 Waddell G, Newton M, Henderson I, Somerville, Main C. The Fear Avoidance Beliefs Questionnaire and the role of Fear Avoidance beliefs in chronic low back pain and disability. Pain. 1993;52:157–168.

2 Kendall NAS, Linton SJ, Main CJ. Guide to assessing psycho-social yellow flags in acute low back pain: risk factors for long-term disability and work loss. Accident Compensation Corporation and the New Zealand Guidelines Group. Wellington, New Zealand. 1997. October 2004 Edition.

3 Linton SJ, Shaw WS. Impact of Psychological Factors in the Experience of Pain. Physical Therapy. 2011;91(5):700–11.