Do You Wake Up and Immediately Check Your Pain?
You haven't even opened your eyes yet, and your brain is already running its morning diagnostic test: How bad is my neck today? Is my lower back throbbing? Oh no, is that headache back?
Before your feet hit the floor, you're already gathering data to determine what kind of day you're going to have. Sound familiar?
It makes sense. When you've lived with chronic pain, you want to know what you're dealing with. Checking your body feels like a sensible way to prepare, protect yourself, and avoid making things worse.
But what if this seemingly helpful habit is actually keeping your pain alarm switched on?
In Pain Reprocessing Therapy (PRT), we call this hypervigilance: constantly monitoring your body for signs of pain or danger. And although this habit develops for good reason, it can sometimes reinforce the very pain you're trying to escape.
How Hypervigilance Keeps Chronic Pain Going
Your brain is remarkably adaptable. Through a process called neuroplasticity, it learns from repeated experiences and strengthens the pathways it uses most often.¹ When your attention repeatedly returns to a painful area, especially with fear or anticipation, your brain can become increasingly sensitive to sensations coming from that area.
Think of your nervous system like an amplifier. When you're relaxed, you might barely notice a little muscle tension or pressure from sitting. But when you're hypervigilant, you turn the volume up to 11 and listen intently for the slightest noise. Before long, even ordinary background sensations can sound like a five-alarm fire.
For some people with chronic pain, this creates a self-reinforcing loop:
You notice a twinge—or start searching for one
Your brain interprets the sensation as a possible threat
Fear activates your fight-or-flight response
Your nervous system becomes more alert, and muscle tension and pain sensitivity may increase
You notice more sensations, which seem to confirm that something is wrong
Research on primary chronic back pain supports the idea that fear and beliefs about pain can help maintain this cycle.² The pain you feel is real; the problem is that your brain may be misinterpreting safe sensations as dangerous. When this happens, your brain creates pain to signal danger where there might not actually be any.
Sneaky Ways You Might Be Feeding the Pain Loop
Hypervigilance isn't always obvious. You might recognize yourself in a few of these everyday habits:
The “Is It Safe to Sit?” Test: Checking how firm a chair is, calculating how long you can sit before your back flares, or mentally mapping every potential exit strategy.
The Phantom Touch: Poking, rubbing, stretching, or pressing your neck or jaw to see whether it still hurts. Because apparently, the pain needs a daily performance review.
The Weather Forecast: Checking barometric pressure or looking at your upcoming workweek schedule and bracing for a flare before anything has happened.
The Emotional Audit: Receiving a stressful email and immediately checking, Did that just make my stomach hurt? Is my headache getting worse now?
None of these behaviors means you're doing something wrong. They're understandable attempts to feel safe and regain control. But repeatedly checking for danger can teach your brain to keep looking for it. And even if it doesn’t find any, it’ll create some pain anyway to match the level of danger it perceives. (Such troublemakers, these brains of ours!)
Again, not your fault, or something you’re doing on purpose. In fact, not even likely something you’re consciously aware of. But there are whole portions of our brains that operate beneath our conscious level of awareness. The good news: we can retrain them to stop being saboteurs.
What I Learned During My Own Chronic Pain Journey
I spent three years living with chronic pain, so I understand how all-consuming it can become. When pain keeps showing up, monitoring your body can feel less like a choice and more like a full-time job you never applied for.
Hypervigilance isn't a character flaw. It's a brilliant survival mechanism. If there were a tiger in your living room, constantly checking where it was would be an excellent idea. The trouble starts when your nervous system keeps responding as though there's a tiger even when it’s a a house fly.
One of the most important shifts in my own healing was recognizing that continually looking for pain could inadvertently reinforce my brain's sense of danger. I didn't need to become better at detecting every sensation. I needed to help my brain learn that merely noticing sensations didn't automatically mean I was in danger.
I ultimately healed completely through Pain Reprocessing Therapy, and that lived experience is part of why I'm passionate about helping others find a different way forward.
From Hypervigilance to Outcome INDEPENDENCE
So, how do you break the cycle? The goal isn't to ignore your body, force yourself to think positively, or pretend pain doesn't exist. It's to change your relationship with sensations and gradually build a sense of safety.
1. Catch the scan without judging yourself. When you notice yourself checking your neck, poking your back, or predicting a flare, gently name what's happening: “Ah, there I am checking for danger again.” No shame, no scolding. Just awareness.
2. Practice somatic tracking. If you’ve already ruled out medical concerns and determined it’s neuroplastic pain*, try observing the sensation with curiosity rather than fear. Notice its qualities: “There's some warmth, a little buzzing, and some pressure.” You don't have to figure out why it's there or make it disappear. In PRT, this practice can help you experience sensations with less threat and fear.² It’s called practicing “outcome independence”— in layman’s terms: not caring whether the pain stays or goes, because it’s not actually dangerous. Once your brain realizes that, it will stop signaling danger and creating more pain.
3. Take a break and redirect your attention to something positive. You don't have to spend all day in a staring contest with your pain to prove you're healing (in fact, please don’t do this, as previously discussed, it’ll only make things worse). Instead try one of these:
Go inward (Leaning into positive sensations): Find a neutral or comfortable area of your body and rest your attention there for a while. Let yourself enjoy the positive sensation, or at least the relief from solely focusing on negative ones.
Go outward (Positive affect generation): Look out the window, enjoy the sunshine, pet a dog, listen to your favorite song, or get absorbed in something you love. Let yourself enjoy a break from staring down your pain for a hot second, and get back in touch with something that makes life worth living.
These small moments of safety, curiosity, and enjoyment help you practice living your life rather than organizing every moment around pain.
*Wondering whether your pain might be neuroplastic? You don't have to figure it all out on your own. I've shared more about the signs that pain may be driven by the brain's learned danger response, and how to recognize whether Pain Reprocessing Therapy might be a good fit, on my chronic pain therapy and coaching page and in my other chronic pain blogs. Understanding the bigger picture can help you approach your pain with more confidence and less fear, rather than feeling like you need to investigate every twinge. If you're unsure whether this approach fits your situation, I'm happy to talk it through with you during a free consultation.
Ready to Stop Feeding Your Chronic Pain?
Are you tired of the fear-pain loop running your life? You don't have to spend every morning wondering how much pain you'll have or every evening replaying what might have triggered it.
I'm trained in Pain Reprocessing Therapy, and I've experienced firsthand how life-changing this approach can be. If you're curious, you can learn more about whether PRT might help you let go of hypervigilance and ease your chronic pain.
I also offer free consultation calls so we can talk about what you're experiencing, explore how I might help, and discuss ways to get you back to living your life—not just monitoring it.
References
Kleim, J. A., & Jones, T. A. (2008). Principles of experience-dependent neural plasticity: Implications for rehabilitation after brain damage. Journal of Speech, Language, and Hearing Research, 51(1), S225–S239.
Ashar, Y. K., Gordon, A., Schubiner, H., et al. (2022). Effect of pain reprocessing therapy vs placebo and usual care for patients with chronic back pain: A randomized clinical trial. JAMA Psychiatry, 79(1), 13–23.