The most common symptom reported to healthcare professionals is pain. It is the main reason for visits to physiotherapists and lost workdays. It also has a significant negative impact on the sufferer, their loved ones, and society at large. 

Pain is a common symptom not only in general medical care and specialty pain clinics but also in mental health and drug addiction treatment settings. 2

Pain is described as “an unpleasant sensory and emotional experience associated with actual or potential damage, or described in terms of such damage” by the International Association for the Study of Pain. 1

Pain can draw attention to itself. Your focus on the cause is a clear requirement for pain perception. Pain is vital as a warning sign since it should draw attention to the injury and prompt proper action.

There is a link between worry, anxiety, fear, and pain awareness. 3

What Is The Connection Between Emotions and Pain?

Emotional distress is one of the most disruptive aspects of pain. Psychological mechanisms are known to facilitate the transition from acute to chronic pain disorders.

The typical emotional reaction to pain includes 

  • Fear, 
  • Guilt,
  • Anger, 
  • Anxiety,
  • Frustration, 
  • And depression. 3

Your ability to control these emotions affects your pain. Emotions significantly influence your behavior and directly affect how you perceive pain. Pain, therefore, induces unpleasant feelings that range from bearable to dreadful.

Worry and anxiety are common feelings because pain can seriously threaten your well-being.

Those who do not experience continuous pain have much greater rates of anxiety disorders than people with persistent pain. 

One type of anxiety that has significant effects (e.g., on your cognition, attention, and behavior) is fear. Intense reaction is a characteristic of fear that prepares you for “fight or flight.” But fear has a short life. 

Worry is more prevalent and defined by frequent mental intrusions that make you consider extremely unfavorable and unpleasant “what if” scenarios. 

A common and powerful emotional state that can influence pain perception is a sad mood (Depression). Depression is a mental illness marked by a bad mood, hopelessness, and despair. Depression is a significant risk factor for disability and may cause increased degrees of pain intensity. 3

Can Physiotherapy Help You Cope With Pain And Emotions?

There are psychologically informed physiotherapy therapies for various muscles and joint disorders. Such approaches include graded activity/exposure, cognitive-behavioral, and acceptance and commitment therapies. The treatment handles pain and emotions.

You can receive these interventions in various ways, including group or one-on-one, face-to-face or online. 4

When the cause of pain is attended to and perceived as a threat, defense mechanisms start working. These methods may comprise a variety of mental and overt behavioral strategies considered to lessen the danger of pain, including relaxation and self-statements. 

You learn behavioral, cognitive, and emotional processes. They are all integrated into coping mechanisms. 3

Other physiotherapy treatment for pain includes

  • Electrical stimulation
  • Manual therapy
  • Thermal Agent
  • Acupuncture 5


The brain areas that express feeling and pain suggest that pain can impact how unpleasant emotions are processed.

Pain has a connection to anxiety, fear, social rejection, attachment insecurity, and high arousal of negative emotions; these emotional components not only occur in reaction to pain but also cause, maintain, or exaggerate pain.

The physiotherapy strategy targets the pain and the emotions.


Gilam, G., Gross, J. J., Wager, T. D., Keefe, F. J., & Mackey, S. C. (2020). What is the relationship between pain and emotion? Bridging constructs and communities. Neuron, 107(1), 17-21.

Lumley, M. A., Cohen, J. L., Borszcz, G. S., Cano, A., Radcliffe, A. M., Porter, L. S., Schubiner, H., & Keefe, F. J. (2011). Pain and emotion: a biopsychosocial review of recent research. Journal of clinical psychology, 67(9), 942–968.

Linton, S. J., & Shaw, W. S. (2011). Impact of psychological factors in the experience of pain. Physical therapy, 91(5), 700-711.

Smart, K. M. (2023). The biopsychosocial model of pain in physiotherapy: past, present and future. Physical Therapy Reviews, 1-10.

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