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The Connection Between Pain and the Brain: The Psychology of Pain Blog Series 1

How do your thoughts and emotions affect your pain? In this exclusive interview, Dr. William Deardorff—a clinical psychologist specializing in pain management—shares his insights.

Dr. Deardorff specializes in the connection between chronic pain and the brain.
Chronic Pain As a Disease: Why Does It Still Hurt?


Veritas Health:

How did you become interested in the psychological side of chronic pain, and in particular the chronic back and neck pain?

Dr. Deardorff:

I have always been interested in mind-body influences on health.

When I was a psychology intern, I trained with one of the pioneer pain psychologists, Dr. Wilbert Fordyce. While working on his pain rehabilitation unit, I observed amazing results in terms of treatment outcomes.

Chronic back pain patients would come in barely able to walk, taking a lot of pain medicines, and often very depressed.


Narcotic pain medicationSometimes pain meds are not the answer for patients in chronic pain.
Medications for Back Pain and Neck Pain


The 19-day inpatient program included intensive exercise, cognitive treatments, relaxation training, sleep stabilization, tapering of pain medications, among other things. In most cases, the results were truly phenomenal. In the program, all the powers of the mind and body were utilized to fight the pain.

The mind-body connection is especially important in the area of chronic back pain. How one thinks about the pain can greatly impact how it is coped with.

Consider a dramatic example that represents a real patient I treated: A woman presented with fairly severe pain in her back, and she was firmly convinced it was due to a cancerous tumor.

Metastatic Spinal Cancer VideoSpine cancer is rare, but the fear of having it can make your pain worse.
Metastatic Spinal Cancer Video


Her emotional response demonstrated a high level of suffering including fear, depression, and anxiety. Our treatment team obtained an MRI and anatomically her spine was found to be OK. Her pain was real, but it was likely due to a severe muscle sprain/strain and was not life threatening.

Within seconds of getting the news, her emotional response changed dramatically from fear and depression to relief. In this case, the actual pain in her back did not change; the only thing that changed was her belief about the threat of pain and the subsequent emotional response. This illustrates how changing beliefs or thoughts about pain can change a person’s emotional response or level of suffering in response to it.

Lower back strainEmotional response to pain can have a significant impact.
Lower Back Strain Video


The interplay between the mind and body is particularly important in the area of chronic pain, especially back pain. This is why we often see very different pain experiences between patients with the same back injuries or physical findings. Some patients with severe physical problems related to their backs suffer a lot both in terms of the pain and related problems, such as depression, lack of activity, medication side effects, poor sleep, etc. On the other hand, many patients with the same severe physical findings suffer a lot less. Their pain perception might be the same, but their level of suffering in response to the pain is quite different. This response to the pain is where a pain psychologist may help.

How to Relieve Neck Pain Caused by Stress

There’s no question that tension and stress can manifest itself in the body. Whether it’s a headache or tight muscles, psychological factors can take a toll on our physical body.

women with neck pain at doctor consultationIf stress-induced neck pain does not subside after a week or two of self-care, see your doctor for diagnosis and treatment. See Treatment for Neck Pain

One of the most common sites in the body where the effects of stress can be felt is the neck. From the base of the skull to the top of your shoulders, your neck can become a center of pain and tension as stress and worries build.

How stress triggers pain

Stress-induced neck pain is defined as pain that is either triggered or worsened by psychological or emotional factors. For example, the initial neck pain may be caused by an injury that strains the muscles in the neck, but the pain continues for days or weeks afterward as stress caused by the injury or other factors builds—maybe even long after the muscle tissue has healed from the initial accident.

That’s not to say that stress-induced neck pain is “all in your head”—the pain and symptoms are very real. It’s just that the causes are not physical in nature.

Some experts think that stress-induced neck pain is caused by a physical factor: namely, a low but constant level of activity in the trapezius muscles that stretch from the back of neck out to the upper shoulders. However, studies found no correlation between neck pain and muscle activity.1 The only positive connection was between neck pain and perceived tension/stress.

6 tips to tackle stress-induced neck pain

By focusing on ways to treat both the mind and the body, you can help lessen stress and the toll it can take on you. Try these methods to manage stress-induced neck pain:

    1. Neck stretches
      If done regularly, stretching exercises for the neck can loosen muscle tightness and maintain or expand range of motion for the neck. Try these 2 stretches to get started.
    1. Therapy or support group
      Cognitive behavioral therapy has proven benefits for helping to develop healthy thought patterns, but even a support group or online forum where you can share your concerns and receive support can help you manage day-to-day stressors.

Visit our very active Healthmaxxcare Forum to find online support.

  • Meditation
    Practicing meditation is a good way to calm your thoughts and anxieties. Look for a guided meditation video on YouTube or attend a class to learn how.
  1. Enlisting help from family and friends
    You don’t have to tackle stress alone; let your family and friends help carry the load. Be clear about ways they can help you—ask if a friend can run an errand for you, or assign your children extra chores around the house during stressful periods.
  2. Massage
    Massage is not only relaxing and stress-relieving overall, but it can specifically ease the tightness of the muscles of the neck and shoulders.

  • Exercise
    Exercise is good for your body and mind. It releases endorphins, a hormone that dulls pain and generates feelings of well-being.
  • Prioritizing
    You’re not a superhero—let inconsequential things go if they’re taking a toll on your health. Focus on what’s most important and don’t worry if things further down the priority list get delayed or undone for a while.


If your stress-induced neck pain is not relieved by a week or two of self-care, see your doctor. He or she can offer other treatment option and diagnose possible underlying conditions.