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Mental Health And Pain

I will preface this by stating the obvious; we are not mental health experts or see ourselves as primary treaters of mental health. What we can speak on are the physical manifestations of mental health and pain and how the two are deeply connected and rooted to create a feedback loop.

To overly simplify here is what we mean by a feedback loop. Imagine a traffic circle with only two exits. One exit is mental health and the other is pain. So we have two areas that feed into this roundabout. We have those dealing with mental health problems who may have increased anxiety, catastrophization, decreased self efficacy, and altered perceptions among others. We also have those enduring pain who may be stressed, hopeless, discouraged, and depressed about not being able to do the activities they love or live a high quality lifestyle. So we have this loop where mental health can drive the pain experience and also pain can drive the mental health influence.

But first let’s talk about pain. Why does pain matter? Understanding pain biology changes the way people think about pain, reduces its threat value and improves their management of it.

  • Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage as explained by the international association for the study of pain.

When we have pain our body can respond in different ways which results in different manifestations.

Looking past just a biomechanical model which simply implies that if you have an ankle sprain you will have pain. This promotes unrealistic “high expectations” on the part of patients that a provider can “cure” their pain alone by focusing on the pain generator. This model does not account for other variables psychologically or socially that may drive the pain. For instance someone may be fully healed, strong, and healthy but they still have loads of fear surrounding re-injury. Maybe they lost their job because they couldn’t meet the demands so they have other complex issues driving the pain experience.

The biopsychosocial model evaluates the integrated “whole person,” with both the mind and the body together as interconnected entities, recognizing biological, psychological, and social components of pain and illness.

The greatest strength of the biopsychosocial model of pain is that it can help explain the large inter-individual differences we see in pain presentations. Instead of chalking these differences up to Nature versus Nurture, the biopsychosocial model helps us to understand the whole pain experience. A biopsychosocial perspective also tells us how a patient interprets their pain. Unhelpful interpretations can lead to mood problems like anxiety and depression, as well as unhelpful coping strategies that limit a person’s potential to heal.

The physical manifestations of mental health can be seen through central sensitization and elevated pain perceptions, decreased sleep and recovery, altered cognitive function and motor planning for movement, muscle inhibition and protective tension in certain body regions, and increased inflammation through altered cortisol regulation and production.

Movement is directly related to and can improve each of:

Emotion and Mood


Cognitive Functioning


Neuro inflammation

which all are negatively impacted by mental health complications. How can we expect someone who is struggling with mental health to move and sweat when just the act of getting out of bed and dressed every morning is difficult. We have to find alternative methods to move and get you in a state of accepting that movement for what it is with intentionality.


By activating the parasympathetic nervous system which is responsible for rest, relaxation, and digestion; through breathing.


Posture is not innately bad but we find that when things are not calm (like with states of mental health and pain) we tend to live in this closed down posture. Moving through those positions to the opposite end range can be both calming and freeing. It’s like hitting reset on the system to make you feel proud and powerful. You have to move slowly and own these positions. It gives you something to lock into and feel.



The act of touch and putting your hands on someone is extremely therapeutic and healing by nature. It can be extremely relaxing and calming for those who feel constant anxiousness and tension.


Movement impact everything we do. Cognitively, emotionally, and behaviorally: three key areas we can positively adapt regarding the pain and mental health loop. We can modify how we view and think on our pain. We can alter the negative emotions that accompany pain , and we can alter how we respond with our behaviors during a pain experience. These are just four simple ways we come alongside others dealing with mental health and pain to lead them back to movement when all seems lost. We hope you know that is it okay to not be okay and that you are relentlessly powerful and capable of moving yourself to a better space and place.



Dr. Bryan Keith

Myomuv PT

We help active adults and athletes return to the activities they love without pain, without taking time off, and feeling more confident and capable than ever before.