Regulating Thoughts And Emotions To Control Pain

Two people with the exact same disease can have very different outcomes. Why is that?

A large part of this is due to how each individual perceives the disease and the changes that the disease has made to his/her life. Having negative thoughts and emotions is absolutely normal when going through a life altering experience; however, the way in which you deal with these thoughts and emotions can significantly affect your recovery. The good news is that you have a great deal of control over how you regulate your thoughts and emotions.

The three most common emotions linked with chronic pain are fear, sadness and anger.


People with chronic pain will have fear of certain movements and activities because they believe that pain from those activities is a sign that they're harming their bodies. This fear is common and can help to protect you from worsening the pain. However, if you restrict your activities too much because of the pain, your body will get weaker and stiffer - which will perpetuate the pain.

What we generally recommend to our patients is that you should continue to be active by doing a little bit at a time. Feeling a small amount of increased pain is normal but if the activity causes more intense pain that lasts for more than 30 minutes after you've stopped doing it, then avoid performing the activity on a regular basis. But before you avoid the activity altogether, try to step back and look at how you’re performing the task. Consulting with a clinician who specializes in movement can help you pinpoint poor movement patterns. Most activities can be modified so that it is less painful. Once you feel more confident in your abilities to do things without increased pain, your fear will decrease.


It's natural to feel sad when you have chronic pain because you can no longer do what you were once able to do effortlessly, so you've lost your sense of self. Unfortunately, over time, this sadness can lead to hopelessness and helplessness and spiral into depression. It’s best to address sadness before it becomes depression.

Dealing with sadness requires you to be open to doing things differently. For example, instead of playing hockey, you can coach it...or be the best cheerleader at your children's games. Maintaining strong relationships is another crucial element to fending off depression. Your loved ones can provide you with physical and emotional support. More importantly, they can give you motivation and inspiration to return to a productive and meaningful life.


Many people with chronic pain will experience anger if someone or something else is to blame for their condition. It's a powerful emotion - my team has witnessed anger consume a person’s life and destroy their relationships. The one good thing about anger is that it actually motivates a person to do something whereas other emotions cause a person to withdraw from life.

The timing of when you express anger is very important. Don’t talk to others when you’re in a rage – this will only damage your relationship and hurt your chances of getting what you want out of the conversation. But don’t lock your anger inside either – this will cause your pain to increase or result in you blowing up later. Instead, let the other person know you’re angry so that it opens up the lines of communication. Then literally go cool off – use an ice pack or cold shower or go to a cooler place. Or take some slow, deep breaths. During the time that you’re cooling down, clarify to yourself why you’re angry (if you can) and then use the motivation that anger gives you to let the other person know why you’re angry and ask for what you want from them.

Anger can be especially difficult to let go of when an injured worker feels that they have been unfairly treated by their employer, compensation system or healthcare system. In these cases, it is important to seek advice on how to appropriately advocate for yourself. The Canadian Injured Workers Alliance and Office of the Worker Advisor are independent agencies that can provide information and support.

Dr. Trung Ngo founded Novah Healthcare in 2017, an interdisciplinary clinic that specializes in the conservative management of acute and chronic pain. His Novah clinic will continue the work he did from 2011 to 2017 at Mount Sinai Hospital, where he led an interdisciplinary team in assessing and treating complex, chronic, non-cancer pain. His Mount Sinai team helped patients decrease their pain, improve their daily and vocational functioning and reduce or eliminate their intake of pain medications (including opioids). Dr. Ngo graduated from the Canadian Memorial Chiropractic College and subsequently pursued a residency program at Hamilton General Hospital in which he furthered his training in orthopaedics and pain management.

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