A person clutching at their back, the spine flared with pain and multiple sad face emojis leading up the spine to the brain.

How Pain Affects Emotions

The long-lasting pain associated with chronic arthritis such as axial spondyloarthritis can affect your emotions in addition to your joints. Your emotional, mental, and physical states are connected. Thus, pain in your body influences emotions and vice versa.

Feeling pain

The physical sensation of pain is unpleasant—and so are the challenges that pain often brings. Pain, along with joint stiffness, can impair your physical abilities, resulting in limits to daily tasks, activities, and work. Adjusting to the loss of mobility and other skills can be emotionally and physically hard for people living with AS.

The changes brought on by AS can be distressing and overwhelming at times. On top of the physical pain and limitations come new medical treatments and new ways of doing things, you feel afraid or uncertain about the future and how to move forward.

What a person feels physically and emotionally also affects them mentally. Intense pain can consume your thoughts and make it hard to concentrate. Unresolved anger, loneliness, loss of courage and hope, and sadness may give way to anxiety and depression.

Linking pain and emotions

Although pain influences the mind, it certainly does not exist only in a person’s mind. The pain and the emotions you feel are real. Scientific studies continue to reveal more about how pain and emotions are connected.

A primary link between pain and emotions seems to lie within the nervous system of the human body. The nervous system is made up of nerves or pathways to and from the brain. This system tells the body how to react to changes that occur both inside and outside the body.1

The nerves that deal with pain signals employ some of the same chemicals used to control emotions and mood. As a result, when emotions are not controlled, the sensation of pain increases. It is also true that increased pain upsets emotions.1

Factors that alter the brain can play a role in both physical pain and depression. One of these factors is inflammation. For example, the inflammation that people with AS often have can trigger both pain and depression.2

Managing pain and emotions

There are steps that people with AxSpA can take to manage their pain and their emotions. Treatments exist, and some treatments can address both physical pain and emotional symptoms. A doctor can advise on the best course of care for your situation.

A treatment plan may include a combination of drugs, dietary supplements, and therapy. Antidepressants and other mental health medications, biologics, and nonsteroidal anti-inflammatory drugs are often used to relieve pain and emotional suffering. Physical therapy can improve movement and being able to do more can reduce anxiety and depression. Cognitive behavioral therapy can improve coping skills and lessen negative thoughts.1-3

Drugs may be used alone or in combination with one or more therapies to treat pain and emotional suffering. A 2017 study found that people ages 20 to 70 with chronic back pain had greater improvements in function when their treatment regimen included cognitive behavioral therapy.2

Lifestyle changes can also play an important role in easing physical and emotional symptoms and promote well-being. Suggestions include eating good food, exercising more, and building time for meditation, mindfulness or relaxation into every day. Getting plenty of sleep and reducing stress can also help restore health and quality of life for people living with AS.

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