Living With Chronic Pain

We Can’t Separate Our Emotions From Our Pain

There’s so much craziness in the world. Worry over our health. Financial concerns. National issues that threaten our way of life. Continued issues with how to socialize and interact with others. Tossing and turning at night, unable to let them go. They can all lead to worsening pain.

Emotional pain activates the same areas of the brain as when we feel physical pain- in the anterior insula and anterior cingulate cortex. In one study those who experienced social rejection from their peers or had recently ended their marriages and saw a picture of their ex lit up the same areas as when we are hurt.

Maybe because emotional pain is like an expression that was meant to happen but never actually did. You wanted to scream at your friend for making you late to work when he took too long to get ready but you didn’t actually scream. The residual muscle spasms in your neck, throat and jaw as you suppress the scream is still there. That thoughtless person’s action is still felt as a pain in the neck, literally- or feeling so fed up you actually feel a heaviness in your chest and gut that sometimes makes you physically sick.

All emotions have a motor component. Even when we try to hide them we have micro- expressions, a millisecond muscular activation we can’t stop, that can give us away to those in the know. This is because the anterior cingulate which regulates pain and emotions is located adjacent to the pre-motor area. Once we have an emotional reaction the motor cortex invokes a physical response in specific muscles that express that emotion before we can stop the process.

Rage and anger are felt throughout the body and their brain signals all end up in the same place- where pain resides. The brain isn’t just the boss, it interconnects via neural pathways in the brain stem and spinal cord to every part of the body. Circulatory and lymphatic systems send neurotransmitters which modulate the interactions and feedback between the brain and peripheral nervous system making sure every cell is monitored.

Anger is a powerful emotion. Constantly struggling with the question “why me,” dealing with the challenges chronic pain brings to our lives, its a common coping mechanism. But one that keeps us wound up tight, in a constant state of stress, releasing adrenaline, cortisol and chronic reactive proteins (CRP) that worsen pain. 

There’s an obvious link between physical pain and it location in the body. Even though the processing of all pain occurs in the brain, the actual location is tagged in the inciting area. The neural, blood and hormonal responses get more and more specific information about where they came from as they ascend to the spinal cord, brain stem, and thalamus. Until the awareness is solidified in the insula, parietal and motor corticies that define a unique, complex and 3D image that makes it clear the pain is in the elbow.

Human beings are multifaceted. All aspects of our environment, interactions, health, and emotions have an impact. Trying to separate the physical from emotional responses is impossible. Even the brain circuitry prevents it. We are what we feel, and how we feel affects who we are. Accepting this makes treating, and lessening pain easier.

It’s not all in or head. Or if truth be told, everything is in our head. That broken bone, fever, ruptured appendix, sadness over a break up, anger over losing a job all reside ultimately in the brain. But pain is not more or less objective than anything else. Especially when we now know it can continue long after the inciting event has resolved.

But it does reinforce how much we need to treat both aspects- the physical and the emotional- if we want to progress. Dealing with the underlying emotions that keep muscles tight and ready to respond but never get the opportunity. We are persistently in a fight or flight state. Just like the yell that is never vocalized when we are angry, frustrated or hurt by someone we can’t respond to, we stay wound up and prepared for any possible reaction, but never released. That perpetual anticipation and worry shreds our muscles, overworks our heart and shuts down unnecessary functions like digestion- leading to GERD, IBS and other concerns.

When we hold onto all that pent up emotion we often act out in ways that we aren’t able to release towards the person or group causing the feelings. Too often this means letting go with strangers. A great example is road rage. If you find yourself feeling on edge all the time, getting irritated quickly especially with minor issues, or criticizing others for minor infractions, try these options instead:

Work it out

Even a few minutes a day can reset the fight or flight mode back to baseline. Allowing tense, painful muscles to do what they been aching to do- react.

Hit a punching bag

It can be quit cathartic. Physically releasing your feelings onto a bag. Aimed at a particular event or person can help as well when dealing directly isn’t an option. Check out my post where my daughter and I added pictures!

Yelling where no one can hear

Screaming at the top of your voice can be a terrific way to let loose and tell the universe how you’re feeling. 

Put it all on paper

Taking the time to write down your feelings and put them into words can be a wonderful way to heal. If appropriate, send it to the person of interest. If you just needed to vent,  ripping it into pieces can work too. 

Talk it out

Talk with the offending party, a friend or counselor. Saying your feelings out loud can often be enough to move on. But when friends and family can’t help call a professional. They aren’t there to tell you what to do, just to offer perspectives and options that may otherwise be missed or ignored.

Use a pillow

 Have a pillow fight while verbalizing your concerns. A safe way to physically connect while explaining the pain and anger can often move us forward. But if it ever feels like it may progress physically stop immediately and get to safety.

Change your viewpoint

In the throes of passion we often forget there are two sides to every discussion. Whether you agree with it, taking the time to think about and put yourself in their shoes may be a way to find common ground and move forward.

Change your environment

Get out. Take a walk. It can change your perspective. Sometimes just a momentary distancing from the inciting event can allow enough time to decompress and calm down.

Dance, draw, paint

Use your creative side to “verbalize” your feelings. Letting loose in ways that aren’t structured, rigid or controlled can help us to better acknowledge and release our worries and fears. At the very least it’ll be an opportunity to spend time using a side many of us rarely express. 


Calm the mind and disengage from the day to day stressors and worries by meditating. Whether it’s a set time each day or practicing techniques like breathing in to the count of five, holding your breath for the count of five, breathing out for the count of five… when needed throughout the day can be a great way to stop the tension and relax.


Accepting where we are and what we can accomplish in spite of the pain. Realizing it doesn’t keep us from enjoying our lives, we do. I may not be able to jog, ski, or lift that 50 lb plant when home alone. But that doesn’t change the fact I can still take care of myself, have fun and live life, just differently. Once I make the pivot from “fix me” or “poor me” to “how do I live with my pain” the rest gets easier. 

Don’t keep it bottled inside. Find resources that work for you and get it out. Your mind, and body, will thank you.




- anger

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