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The "Big Picture" of Pain

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One myth about pain is that it's only a physical problem. In fact, many different factors affect how a person feels pain. We call this the "bigger picture" of pain. Doctors and scientists call this the “bio-psycho-social” model of pain. 

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The bio-psycho-social model includes biological factors – such as a physical injury to the body or a tumor pressing on a nerve; psychological factors – such emotions and thoughts about pain; and social factors including relationships with others. Whatever you call it, the idea is that many parts of a person's life affect how they experience pain. We've included some examples below:

Physical

Of course, there are the physical causes of pain, and physical reasons that a pain may get worse, including:

Growth of tumor

Here are some physical reasons that pain may get better​​:

Tumors shrinking because of treatment

Surgery or complications with treatment

Nerve damage

Infection

Wound healing

Massage or other treatments to reduce muscle tension

Pain medications

Swelling or inflammation

Thoughts / Your Mind

It’s also important to consider how we think about pain. Some types of thinking can make pain feel more severe and can make a person feel more limited by their pain. Other types of thinking can improve pain and help a person cope with it better.

Paying too much attention to pain can make you feel more limited by your pain, and can make the pain feel worse

 

Memories of being in pain can make pain feel worse

  • All or Nothing Thinking
    Am I too extreme in my thinking? Are there other ways of looking at it?
  • Should Statements
    Is this a rule that applies to everyone else? If not, maybe this is a preference rather than a rule.
  • Extreme Negative Thinking
    Am I 100% sure of these awful consequences? Am I jumping to conclusions too quickly? Do I know for certain that this will happen? What other possible outcomes are there? What is the most realistic outcome? What is the likelihood that _______ will happen? What is the worst that could happen? How bad is that and could I cope with that?
  • Overgeneralization
    Does ___ have to equal or lead to________ ? Have I ever had situations in my life when___ did not lead to____? Am I being too extreme in my thinking? Am I jumping to conclusions too quickly?
  • Jumping to Conclusions
    Do I know for certain what the other person is thinking? Do I have telepathic powers? Even if s/he were to think this about me, does __________ 's opinion reflect everyone else's?
  • Emotional Reasoning
    Is my emotional experience necessarily reflective of the situation? Am I reading too much into my emotions? What do I know to be true? Has my emotional interpretation ever led me to the wrong conclusion? Could my emotions or how my body feels be coloring my appraisal of the situation? Will I come up with the same conclusion if I wait 30 minutes?
  • Forgetting the Positive
    Am I being too critical of myself? Am I being fair to myself? Would I believe this person if s/he were to tell me something bad?
  • Mental Filter
    Am I being partial to what I pay attention to? Am I disqualifying the positive? Am I looking at the whole picture? Am I focusing on a negative detail? Would I be this tough on a friend?
  • Fortune-telling
    Do I know for certain that this will happen? Do I have a crystal ball? Could there be any other explanation? Do I have special powers to look into the future? Have I ever been wrong? How accurate have I been when I have foretold the future?
  • Magnification/Minimization
    Am I being too hard on myself? Would I be this tough on my friend? Am I being fair to myself?
  • Labeling/Mislabeling
    What is the definition of ________? Am I being fair to myself by labeling myself? How useful is it to be labeling myself? Is this the only thing that defines me? What more is there about me?
  • Personalization
    Am I reading too much into this? Am I really that powerful? Are there any other reasons unrelated to me why things turned out this way? Could something else be going on?
  • All or Nothing Thinking
    Am I too extreme in my thinking? Are there other ways of looking at it?
  • Should Statements
    Is this a rule that applies to everyone else? If not, maybe this is a preference rather than a rule.
  • Extreme Negative Thinking
    Am I 100% sure of these awful consequences? Am I jumping to conclusions too quickly? Do I know for certain that this will happen? What other possible outcomes are there? What is the most realistic outcome? What is the likelihood that _______ will happen? What is the worst that could happen? How bad is that and could I cope with that?
  • Overgeneralization
    Does ___ have to equal or lead to________ ? Have I ever had situations in my life when___ did not lead to____? Am I being too extreme in my thinking? Am I jumping to conclusions too quickly?
  • Jumping to Conclusions
    Do I know for certain what the other person is thinking? Do I have telepathic powers? Even if s/he were to think this about me, does __________ 's opinion reflect everyone else's?
  • Emotional Reasoning
    Is my emotional experience necessarily reflective of the situation? Am I reading too much into my emotions? What do I know to be true? Has my emotional interpretation ever led me to the wrong conclusion? Could my emotions or how my body feels be coloring my appraisal of the situation? Will I come up with the same conclusion if I wait 30 minutes?
  • Forgetting the Positive
    Am I being too critical of myself? Am I being fair to myself? Would I believe this person if s/he were to tell me something bad?
  • Mental Filter
    Am I being partial to what I pay attention to? Am I disqualifying the positive? Am I looking at the whole picture? Am I focusing on a negative detail? Would I be this tough on a friend?
  • Fortune-telling
    Do I know for certain that this will happen? Do I have a crystal ball? Could there be any other explanation? Do I have special powers to look into the future? Have I ever been wrong? How accurate have I been when I have foretold the future?
  • Magnification/Minimization
    Am I being too hard on myself? Would I be this tough on my friend? Am I being fair to myself?
  • Labeling/Mislabeling
    What is the definition of ________? Am I being fair to myself by labeling myself? How useful is it to be labeling myself? Is this the only thing that defines me? What more is there about me?
  • Personalization
    Am I reading too much into this? Am I really that powerful? Are there any other reasons unrelated to me why things turned out this way? Could something else be going on?

Emotional

Emotions also influence our pain. This means that negative emotions like sadness, anxiety, fear, and anger can all make pain feel more intense. 

 

The opposite is also true. Positive emotions like happiness, humor, or peace can make pain feel better.  These different feelings are all normal parts of life. It’s not about avoiding the emotions but instead trying to find ways to cope with them in the moment.

 

For specific tips, read these articles:

Feelings that make pain worse​​:

Feelings that make pain better​​:

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Actions

Actions you take to respond to the pain can also affect how you feel.

 

  • Stretching or rubbing the area that hurts

  • Guarding yourself from moving parts of your body that hurt

  • Being more or less active than usual

  • Resting more or less than usual

  • Avoiding activities you enjoy or love

Social

It’s hard to spend time with other people when pain is severe. However, research has shown that staying connected to people you care about, and staying engaged in activities you value can help with your pain.

 

Spending time with others can lift your spirits, which helps with pain. Getting support from others can make you feel less alone, and help you think of ways to cope with your pain. Staying connected with your community can also help you be more active, which tends to help pain.

  • All or Nothing Thinking
    Am I too extreme in my thinking? Are there other ways of looking at it?
  • Should Statements
    Is this a rule that applies to everyone else? If not, maybe this is a preference rather than a rule.
  • Extreme Negative Thinking
    Am I 100% sure of these awful consequences? Am I jumping to conclusions too quickly? Do I know for certain that this will happen? What other possible outcomes are there? What is the most realistic outcome? What is the likelihood that _______ will happen? What is the worst that could happen? How bad is that and could I cope with that?
  • Overgeneralization
    Does ___ have to equal or lead to________ ? Have I ever had situations in my life when___ did not lead to____? Am I being too extreme in my thinking? Am I jumping to conclusions too quickly?
  • Jumping to Conclusions
    Do I know for certain what the other person is thinking? Do I have telepathic powers? Even if s/he were to think this about me, does __________ 's opinion reflect everyone else's?
  • Emotional Reasoning
    Is my emotional experience necessarily reflective of the situation? Am I reading too much into my emotions? What do I know to be true? Has my emotional interpretation ever led me to the wrong conclusion? Could my emotions or how my body feels be coloring my appraisal of the situation? Will I come up with the same conclusion if I wait 30 minutes?
  • Forgetting the Positive
    Am I being too critical of myself? Am I being fair to myself? Would I believe this person if s/he were to tell me something bad?
  • Mental Filter
    Am I being partial to what I pay attention to? Am I disqualifying the positive? Am I looking at the whole picture? Am I focusing on a negative detail? Would I be this tough on a friend?
  • Fortune-telling
    Do I know for certain that this will happen? Do I have a crystal ball? Could there be any other explanation? Do I have special powers to look into the future? Have I ever been wrong? How accurate have I been when I have foretold the future?
  • Magnification/Minimization
    Am I being too hard on myself? Would I be this tough on my friend? Am I being fair to myself?
  • Labeling/Mislabeling
    What is the definition of ________? Am I being fair to myself by labeling myself? How useful is it to be labeling myself? Is this the only thing that defines me? What more is there about me?
  • Personalization
    Am I reading too much into this? Am I really that powerful? Are there any other reasons unrelated to me why things turned out this way? Could something else be going on?
  • All or Nothing Thinking
    Am I too extreme in my thinking? Are there other ways of looking at it?
  • Should Statements
    Is this a rule that applies to everyone else? If not, maybe this is a preference rather than a rule.
  • Extreme Negative Thinking
    Am I 100% sure of these awful consequences? Am I jumping to conclusions too quickly? Do I know for certain that this will happen? What other possible outcomes are there? What is the most realistic outcome? What is the likelihood that _______ will happen? What is the worst that could happen? How bad is that and could I cope with that?
  • Overgeneralization
    Does ___ have to equal or lead to________ ? Have I ever had situations in my life when___ did not lead to____? Am I being too extreme in my thinking? Am I jumping to conclusions too quickly?
  • Jumping to Conclusions
    Do I know for certain what the other person is thinking? Do I have telepathic powers? Even if s/he were to think this about me, does __________ 's opinion reflect everyone else's?
  • Emotional Reasoning
    Is my emotional experience necessarily reflective of the situation? Am I reading too much into my emotions? What do I know to be true? Has my emotional interpretation ever led me to the wrong conclusion? Could my emotions or how my body feels be coloring my appraisal of the situation? Will I come up with the same conclusion if I wait 30 minutes?
  • Forgetting the Positive
    Am I being too critical of myself? Am I being fair to myself? Would I believe this person if s/he were to tell me something bad?
  • Mental Filter
    Am I being partial to what I pay attention to? Am I disqualifying the positive? Am I looking at the whole picture? Am I focusing on a negative detail? Would I be this tough on a friend?
  • Fortune-telling
    Do I know for certain that this will happen? Do I have a crystal ball? Could there be any other explanation? Do I have special powers to look into the future? Have I ever been wrong? How accurate have I been when I have foretold the future?
  • Magnification/Minimization
    Am I being too hard on myself? Would I be this tough on my friend? Am I being fair to myself?
  • Labeling/Mislabeling
    What is the definition of ________? Am I being fair to myself by labeling myself? How useful is it to be labeling myself? Is this the only thing that defines me? What more is there about me?
  • Personalization
    Am I reading too much into this? Am I really that powerful? Are there any other reasons unrelated to me why things turned out this way? Could something else be going on?
Want to learn more?
Check out these articles:
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© Desiree R. Azizoddin, Board of Regents of University of Oklahoma, 2022.

© 2022 Dana-Farber Cancer Institute, Inc. (Dana-Farber). All rights reserved.

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