What’s Causing My Pain?

Cause and Effect
Bodies are more complex than simple cause-and-effect

We have a deep need for things to make sense. Knowing what happens and why gives us a feeling of some control and order in the chaos of life. Research shows that humans are wired for pattern seeking and storytelling. “Everything in our brain is looking for the cause-and-effect relationship of something we’ve previously experienced.”1

So when we have an ache, pain or physical difficulty, it’s no surprise we run through the rolodex of our past experiences to make sense of what it is, why it’s happening, and how to resolve it. The problem is when we become overly attached to finding a single, direct cause-and-effect explanation and close ourselves off to the complex realities and opportunities.

Our minds and bodies are highly complex, interconnected and ever-changing. We delude ourselves when we think a pain or difficulty can be viewed in isolation. While pursuing the answer or a quick fix may work occasionally, more often recovery from pain and health issues isn’t so cut and dry.

Pain Is a Two-Way Street

Pain science
Pain is an experience in your brain

It used to be thought that pain was primarily a one-way street—injured tissues/muscles/joints sent pain signals to our brain. We now know in addition to this “ascending” information from body to brain, there’s also a “descending” path from brain to body that modulates our experience of pain.  The state of your tissues is weighed with a range of psychological and social factors including memory, mood, stress, expectations, amount of social support, and the attitude you have toward your pain. In this way, pain is an experience that happens in your brain.2

Pain is designed to ring our alarm bells, so it’s not easy to be calm and relaxed about it. When pain persists despite efforts to remedy it, we tend to double down on the cause-and-effect approach. “When we feel like we don’t have command of our own fate, our brains often invent patterns that offer a sense of self-control.”3 “And we are quite adept at telling stories about patterns, whether they exist or not.”4

What Stories Do You Tell About Your Pain?

Your pain story
How do you know your story is true?

The more times we tell a story, the more likely we are to believe it is fact. We tend to solidify the diagnosis from our doctor, what we’ve read on the internet and other assumptions into unquestionable truths, then ignore information that doesn’t fit our storyline. We might stop doing activities because we’ve heard they’re bad for the type of pain we’re experiencing. We may continue exercises, stretches or medications even when they leave us in more pain because with think they should help. But the biggest problem of looking for the answer is that we stay in our head while ignoring our body.

You Are the Expert on You

While doctors and health practitioners serve a much-needed purpose, you are the expert on you. It’s amazing what you can learn when you tune into your sensations, breathing, comfort level, feelings, etc. Insights and intuitions emerge, your understanding of what helps and what hurts becomes clearer, and you start to know when to take a break before you overdo.

When you don't know
Hold your diagnosis lightly, ask more questions and stay open

Even if none of this happens, the mere act of listening to and moving attention around your entire body (rather than staying focused on just the painful area) can lead a little easier movement and breath, and more ease mentally and emotionally in relationship to the pain.

So what would it be like to step back from finding the explanation or quick fix to your problem? What if instead, you opened into a space of not knowing? You might get curious, ask yourself questions, explore, make little experiments and stay available to a range of inputs? How would it be to cultivate acceptance of what you’re experiencing in the moment? Accepting your pain doesn’t mean resigning yourself to it. It’s possible to accept pain or difficulty while continuing to take steps to help yourself.

Keep Moving, Even with Pain

It’s also important to keep moving, to the extent that you can, especially when you have a chronic issue. Of course, some activities will be off the table. But avoiding using parts of yourself or cutting out moving for long periods of time may just maintain the problem—or even generate new ones.

How to Tell If It’s Okay to Do an Activity

Sometimes you’ll be in more pain after doing an activity. A guideline for deciding whether to continue doing that activity is to check in with yourself the next day. If you return to your baseline level pain, do the activity again and notice how you feel the next day.

I don't know and that's okayIf your pain is still higher than baseline the day after the activity, take a break from or modify it (e.g. by doing less, going slower, changing how you do it, etc.). Remember to be gentle with yourself. You can’t always anticipate what will aid or exacerbate your symptoms. This is a trial-and-error process in which mistakes and set backs are normal; just look for a gradual trend toward improvement.

Give It a Go: Open to the Unknown

The next time you have pain or difficulty, I encourage you to first acknowledge your mind’s desire to find the answer, then let it go and drop into your body and sensations. You are your best teacher. Your body is resilient, resourceful and highly intelligent!


Learn to Listen to Your Body and Build Your Self-Care Skills

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  1. The Science of Storytelling by Leo Widrich
  2. A great resource for the biopsychosocial model of pain is Explain Pain by David S. Butler and the ExplainPain.org website
  3. 60-Second Science podcast by Adam Hinterthuer
  4. The Pattern Behind Self-Deception, a TED Talk by Micheal Shermer