What’s in your go-to pain management toolkit? Maybe you rely on some combination of ice packs or heating pads, massage, or pain medication. These common tools work to varying degrees, but they all focus on the physical aspect of pain.

Your nervous system is also deeply involved in your pain experiences. Your thoughts, emotions, and physical sensations are very intertwined. When physical pain is present — a flare-up of knee pain or a tweak in your back — it’s likely that you feel strong emotions, such as frustration, sadness, anger, or anxiety. Here we go again, you might think. My pain will never get better.

This mindset can further fuel the physical pain you’re experiencing.

With that in mind (pun intended), there is one pain management tool that often gets overlooked, but is instrumental in living a life with less pain: your self-talk.

The Scoop on Self-Talk

Self-talk is the inner monologue that goes on inside your head. Positive self-talk has beneficial effects on your emotions, self-efficacy (the belief that you can achieve something), stress levels, and even your resilience to illnesses.

In the case of pain, research has shown a direct relationship between positive self-talk and reduced pain scores. This is not saying that you can literally talk yourself out of feeling pain. This is not gaslighting. Rather, it’s taking a broad, holistic look at all the factors that influence how your nervous system processes pain. When you experience greater levels of positive emotions, it leads to more resilience, which equips you to handle difficult situations, including pain.

In one such study involving people living with chronic pain, participants had a 10-minute session that focused on restructuring their thoughts via self-talk techniques. This intervention resulted in reduced pain catastrophizing (when you think the worst), increased pain tolerance, and reduced subjective pain scores.

How to Talk the Self-Talk

First, it takes time, practice, and patience. Then think about these two steps: You need to catch your thoughts, then check your thoughts.

Catch your thoughts by asking yourself:

• What was I thinking the last time I experienced pain?

• What was the situation?

• What emotion was I feeling?

Check your thoughts by asking yourself:

• Is this thought true?

• Will this thought always be true?

• Is it helpful to think this way?

Once you’ve taken stock of your past thoughts, the next step is to reframe them.

1. Remove intensely negative, extreme, and emotional words. This allows you to acknowledge your pain without catastrophizing it.

Thought: I will never feel better. Reframe it: I am feeling pain at this moment, but that doesn’t mean it will last forever.

1. Shift from using “I” to your own name. This allows you to see yourself from an outside point of view and provides more objectivity (and less of a strong emotional reaction) to the situation. It’s also easier to give kindness to that “other” person.

Thought: How am I going to do this? I haven’t done squats in years! Reframe it: Jane, you can do this. You are stronger than you realize.

Prepare for Future Flare-Ups

Pain flare-ups are mentally draining. And it’s harder to test drive self-talk techniques when you’re physically and mentally wiped. To combat this, write out a list of reframed statements in the “Notes” app on your phone when you’re feeling okay. Here are some ideas to get started:

• My pain is here today but a new day is around the corner.

• I am in the driver’s seat when it comes to my pain management.

• I am sore, but safe.

• My body is resilient and capable of healing.

• My pain does not define me.

• I am confident this pain will pass.

• My body is not against me. It is doing the best it can to support me.

• My body is healing, even if it feels slow.

• I trust my body because I know it’s strong and reliable.

Starting a positive self-talk practice can feel bizarre at first, especially if you don’t do this in other areas of your life (like meditation). Some of the people I’ve coached over the years report that it has become one of the most effective parts of their pain toolkit. There’s so much about living with chronic pain that can beat you up and wear you down. Don’t add your own voice to that list.

References:

• Positive thinking: Stop negative self-talk to reduce stress. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/positive-thinking/art-20043950. Published February 3, 2022. Accessed May 18, 2022.

• Pulvers K, Hood A. The role of positive traits and pain catastrophizing in pain perception. Current Pain and Headache Reports. 2013;17(5). doi:10.1007/s11916-013-0330-2

• Starecheski L. Why saying is believing - the science of self-talk. NPR. https://www.npr.org/sections/health-shots/2014/10/07/353292408/why-saying-is-believing-the-science-of-self-talk. Published October 7, 2014. Accessed May 18, 2022.