cognitive behavioural therapy and the connection between psychological stress and chronic pain

get healthing in your inbox with the morning checkup and weekender newsletter!

the mind-body connection can worsen chronic pain, showing that psychological approaches alongside physical ones can be beneficial.

by angelica bottaro

published feb 24, 2025

3 minute read

join the conversation

3 minute read

join the conversation

because the brain interprets both physical and psychological stress in the same way, researchers believe that there is a connection between chronic pain and chronic stress. getty images

chronic pain is sometimes considered a mysterious ailment, and roughly eight million canadians live with it each day. treatments for chronic pain range from various painkillers to physical therapy and, in some cases, a psychological approach.

since both physical and psychological aspects can drive chronic pain, medical professionals have now found that cognitive behavioural therapy (cbt) may address the condition’s mind and body connection.

chronic pain and psychological stress

chronic pain and stress often go hand-in-hand, regardless of what is driving the pain. for example, chronic pain derived from a physical ailment can cause the brain to change how it perceives pain. psychological stress can also heighten a person’s perception of pain.

this is known as the pain-stress cycle. in this cycle, a person experiences chronic pain over a period of time, gets used to waking up with the ailment, and then feels added stress in their daily life. because the brain interprets both physical and psychological stress in the same way, researchers believe that there is a connection between chronic pain and chronic stress.

when the brain responds to chronic pain with a stress response, it also makes matters worse by causing the muscles to tense, affecting sleep, and increasing a person’s sensitivity to pain. the psychological fear or anticipation of pain also heightens symptoms of chronic pain by driving physical symptoms, creating a cycle of emotional and physical exhaustion.

having negative thought patterns surrounding pain can also cause the brain’s reward centre to decrease its ability to experience pleasure, making matters worse psychologically. this double-edged sword makes it more difficult for people to do what they need to do physically to improve their chronic pain due to worsened anxiety, depression, and fatigue.

using cognitive behavioural therapy to tackle chronic pain

researchers have found that tackling chronic pain through the mind is a way to alleviate and reduce the effects of the pain stress cycle. while it’s not considered a cure, it can contribute to a well-rounded approach to chronic pain treatment by addressing mental stress that worsens pain in individuals living with various chronic pain conditions.

it does this by teaching people ways to tweak their brains’ responses to pain signals and helping them identify patterns of thinking that contribute to the physical symptoms of stress.

cognitive behavioural therapy can also reduce the pain-stress cycle by helping people relax, which can lead to a calming of the nervous system that is good for both the mind and the body. in addition, cbt can address avoidance behaviours that often develop due to feelings of anxiety and depression that make it more difficult for people to keep up with their coping mechanisms.

by reframing thought patterns, encouraging muscle relaxation, and using guided visualizations to help people focus on things other than the pain they are feeling, the therapy has become a viable complementary approach to chronic pain.

researchers note that cbt isn’t a treatment that perpetuates chronic pain as a mental ailment but rather shows that the mind-body connection is stronger than people think, and by tackling both aspects of chronic pain, people may be better off.

“i think cbt can play an important role in validating pain, rather than simply identifying how problematic they are and telling people to try and stay positive,” said dr. thomas pontinen, a chicago-based anesthesiologist, in an article in next avenue. “validating these emotional experiences is the first step in turning them into opportunities to learn and build new habits.”

angelica bottaro

angelica bottaro is the lead editor at healthing.ca, and has been content writing for over a decade, specializing in all things health. her goal as a health journalist is to bring awareness and information to people that they can use as an additional tool toward their own optimal health.

cognitive behavioural therapy and the connection between psychological stress and chronic pain

the mind-body connection can worsen chronic pain, showing that psychological approaches alongside physical ones can be beneficial.

chronic pain and psychological stress

how serious does my medical condition have to be to qualify for long-term disability benefits?

the missing measurement: how emerging tools and strategies unlock better quality of life

using cognitive behavioural therapy to tackle chronic pain

advertisement

cognitive behavioural therapy and the connection between psychological stress and chronic pain

the mind-body connection can worsen chronic pain, showing that psychological approaches alongside physical ones can be beneficial.

chronic pain and psychological stress

related stories

how serious does my medical condition have to be to qualify for long-term disability benefits?

the missing measurement: how emerging tools and strategies unlock better quality of life

redefining cancer treatment: how one man strives to bring personalized care to all patients

advertisement

using cognitive behavioural therapy to tackle chronic pain

advertisement

share story