Mind Over Pain: How Your Mindset Affects Exercise-Induced Pain Relief

May 28

Many people experience that a good workout can actually ease their pain for a while. This short-term pain relief after exercise is known as exercise-induced hypoalgesia (EIH) – in simple terms, your body’s natural painkiller response to physical activity. But did you know that your mindset and psychological factors might influence how much pain relief you get from exercise? This article will explore what EIH is, how factors like pain catastrophizing (a tendency to think the worst about pain) come into play, and what current research says. We’ll also share practical tips for individuals with chronic pain and fitness professionals to harness a positive mindset for better pain management.

What Is Exercise-Induced Hypoalgesia (EIH)?

Exercise-induced hypoalgesia (EIH) refers to the phenomenon where pain sensitivity decreases after exercise, leading to a period of reduced pain. In healthy people, a single session of aerobic or resistance exercise typically produces a generalized reduction in pain that starts during exercise and can last for some time afterward (pubmed.ncbi.nlm.nih.gov). In other words, a workout often triggers the body’s natural pain-relief systems (such as endorphins and other neurotransmitters), making you feel less pain immediately following the exercise.

However, in chronic pain conditions EIH is less predictable. People with chronic pain don’t always get this post-exercise pain relief; for some, exercise might not change their pain, and for others, it could even temporarily increase pain (pubmed.ncbi.nlm.nih.gov). This variability has led scientists to investigate what factors might boost or block the pain-relieving benefits of exercise. This is where psychological factors, especially your mindset about pain, come into the picture.

The Power of Mindset: Psychological Factors and Pain Relief

Our brains play a big role in how we perceive pain. Pain catastrophizing is one important factor: it means having extremely negative thoughts and feelings about pain (for example, thinking pain is unbearable or will never improve). Essentially, a person who catastrophizes pain tends to magnify the threat of pain and feel helpless about it (frontiersin.org). This kind of mindset can ramp up stress and anxiety, which in turn can influence how our body manages pain.

Researchers have been examining whether such psychological factors can change the amount of pain relief we get from exercise. Does a positive, calm mindset enhance exercise-induced pain relief? Does a fearful or catastrophic mindset reduce it?

Here’s what recent evidence tells us:

A study in healthy adults: In one experiment with healthy young men and women, participants did a brief, moderately intense exercise while their pain sensitivity was measured. The researchers found that, on average, pain sensitivity dropped after exercise (confirming EIH). But interestingly, individuals who reported more negative mood and more catastrophic thoughts about pain didn’t experience as much pain reduction from the exercise (pubmed.ncbi.nlm.nih.gov). In contrast, those with a more positive emotional state (and a supportive family environment) showed greater pain relief after working out (pubmed.ncbi.nlm.nih.gov). In fact, the authors concluded that these psychosocial factors – mood, mindset, and even family context – can affect both how much pain you feel and how well exercise works to relieve that pain (pubmed.ncbi.nlm.nih.gov). This was a key early clue that mindset matters for EIH.
Fibromyalgia findings: Fibromyalgia is a chronic pain condition known for widespread pain and often an impaired response to exercise. Two studies in women with fibromyalgia suggest that what you think and feel about pain can significantly shape your exercise outcomes. In a 2020 daily tracking study, women wore activity trackers and reported their pain and thoughts each day. The results showed that on days when a fibromyalgia patient was more physically active, she actually reported higher pain levels if she also had high pain catastrophizing that day (journals.lww.com). In other words, being active tended to help or hurt depending on mindset: those who consistently feared and magnified pain felt more pain on active days, whereas lower catastrophizing might mean activity wasn’t as painful. Another 2023 study had fibromyalgia patients perform a supervised walking test. It turned out that women who were less physically active in daily life felt more pain and fatigue after the walk – and this was partly explained by their high catastrophizing and the overall severity of their condition (burjcdigital.urjc.es). In short, for people with fibromyalgia, a negative pain mindset (thinking “this will hurt so bad”) was associated with less benefit – or even flare-ups – from exercise. These findings highlight that chronic pain populations can have a blunted or even opposite EIH response, and psychology is a piece of that puzzle.
Mixed evidence and the bigger picture: It’s important to note that not all studies find a strong link between mindset and exercise analgesia. A 2020 systematic review looked at various experiments on EIH and psychosocial factors in both healthy individuals and those with musculoskeletal pain. The review found that most studies did not show a clear association between psychological factors and EIH, with only a few studies reporting that such factors made a difference (pubmed.ncbi.nlm.nih.gov). Due to differences in study designs and generally limited data, the reviewers concluded that we can’t yet draw firm conclusions about psychosocial influences on EIH (pubmed.ncbi.nlm.nih.gov). Supporting this mixed picture, a recent study in chronic low back pain compared pain relief from exercise in people with back pain vs. pain-free individuals. The chronic pain group did show a smaller EIH response during certain exercises (their pain sensitivity didn’t drop as much as it did in healthy people), suggesting some disruption in their pain modulation (pubmed.ncbi.nlm.nih.gov). But notably, that study found no correlation between the size of EIH and psychological measures like pain catastrophizing, anxiety, or fear of movement (pubmed.ncbi.nlm.nih.gov). In other words, the people with back pain as a group had somewhat less pain relief from exercise, but the individuals who catastrophized more didn’t consistently have worse EIH than those who catastrophized less. This tells us that mindset isn’t the only factor at play – biological differences (like how one’s nervous system processes pain) also contribute a lot.

The Bottom Line: Mindset Can Influence EIH, but It’s Not Everything

Putting it all together, research suggests that your mindset can influence how much pain relief you get from exercise – but the relationship is complex. In some cases (especially in certain chronic pain conditions), a high level of pain catastrophizing or negative expectation is linked to smaller benefits or even temporary pain increases with exercise (journals.lww.com burjcdigital.urjc.es). A hopeful or positive mindset, conversely, might amplify the natural pain-killing effects of a workout (pubmed.ncbi.nlm.nih.gov). However, this isn’t a universal rule: not every study sees this effect (pubmed.ncbi.nlm.nih.gov), and some people with chronic pain still get pain relief from exercise despite having anxiety or negative thoughts (pubmed.ncbi.nlm.nih.gov).

What does this mean for you? Essentially, mindset is one modifiable piece of the pain puzzle. It’s empowering to know that by working on our thoughts and attitudes, we might boost our body’s ability to calm pain during exercise. But we should also remember that pain is not “all in your head” – there are real physiological and neurological factors that determine pain and EIH. So, while cultivating a healthier mindset can help, it’s just one part of a comprehensive pain management approach (along with proper exercise programming, medical treatments, etc.). The science is still emerging, but there’s enough evidence to justify paying attention to psychological well-being as part of exercise-based pain relief.

Practical Strategies to Improve Mindset and Enhance Exercise Outcomes

So how can individuals and fitness professionals apply this knowledge? The goal is to create a positive, supportive mental environment around exercise. Here are some evidence-based strategies:

For Individuals Managing Chronic Pain:

Learn about pain and EIH: Educate yourself on how exercise can help reduce pain. Understanding that some muscle soreness or increased pain during exercise doesn’t necessarily mean harm can ease your worries. Knowledge is power – by knowing that your body often releases natural pain relievers during exercise, you can approach workouts with more confidence and less fear.
Reframe catastrophic thoughts: Notice if you have thoughts like “This is unbearable” or “Exercise is going to make my pain skyrocket”. When you catch these thoughts, practice reframing them into calmer, more positive ones. For example, instead of “I can’t do this; it will hurt too much,” tell yourself “I might feel some discomfort, but that’s okay – it usually passes, and I often feel better after I move around.” Reassure yourself that pain flare-ups are not permanent and that you have coping skills. This kind of cognitive reframing can gradually reduce the helpless feeling that fuels catastrophizing.
Start low and go slow: If you’re nervous about pain with exercise, begin with gentle, short bouts of activity and build up gradually. Positive experiences (like noticing that you feel a bit looser or in a better mood after a 10-minute walk) can reinforce your confidence. Small victories help prove to your brain that exercise is beneficial, not something to fear. Over time, as you increase your activity, your body can adapt and your pain may decrease, which further lowers catastrophic thinking in a positive cycle.
Use mindfulness and relaxation techniques: Practices like deep breathing, meditation, or mindfulness can help keep you calm during exercise. If you start to feel your pain or panic rising, try focusing on your breath or the music you’re listening to, rather than zeroing in on the pain. Some people find that doing a body scan or repeating a coping mantra (e.g., “I am strong, I can get through this”) during exercise lowers their anxiety. Reducing overall stress and muscle tension can enhance the pain-relief benefits of the workout.
Celebrate progress and EIH moments: Pay attention to any amount of pain relief you feel after exercise – no matter how small. Maybe your aching knee feels a tad better after stretching, or your overall pain is down a notch for a few hours post-workout. Acknowledge those improvements and remind yourself that exercise had a positive effect. Keeping a journal of workouts and pain ratings can help; you might notice patterns, like “Whenever I do my water aerobics class, I hurt less that evening.” Recognizing these wins boosts your optimism and motivation to continue, which over time can reduce catastrophic outlook.

For Fitness Professionals and Trainers:

Educate and set expectations: Explain the concept of EIH to clients with pain in simple terms – for instance, “Often, exercise can trigger your body’s own painkillers and actually reduce your pain for a while after the session.” Help them understand the difference between normal exercise discomfort and injury pain. Setting realistic expectations (e.g., mild soreness is okay, severe pain is not) can reduce fear. When clients know what to expect, they’re less likely to catastrophize every ache.
Screen for fear and catastrophizing: Use intake questionnaires or informal chats to gauge a client’s pain mindset. Ask questions like, “What worries you most about exercising with your pain?” Listen for language that indicates catastrophic thinking (like “I’m afraid it will destroy my joints” or “If it hurts, it means I’m making things worse”). This gives you a chance to address those fears directly with education and reassurance. Simply validating their feelings (“I understand why you’d feel nervous about that”) and then providing guidance (“research shows that gradual exercise is safe and helpful for your condition”) can start shifting their outlook.
Foster a supportive environment: A positive trainer-client relationship can counteract negative mindsets. Encourage and praise your client’s efforts and improvements, no matter how small. If a client with chronic pain manages to walk an extra five minutes or do one more rep than last week – celebrate it. Positive reinforcement helps replace fear with self-efficacy. Also be patient and avoid showing frustration if a client is anxious or has a setback; your calm confidence can rub off on them. Remember, as one study noted, having a positive support system (even family or social support) predicted better pain relief outcomes pubmed.ncbi.nlm.nih.gov – you can be part of that positive support.
Incorporate pacing and choice: To prevent overwhelming pain flare-ups, practice pacing strategies in your exercise programming. Break workouts into smaller chunks with rest if needed, and gradually increase intensity. Also, give clients some control and choice in their activities (“Would you prefer the bike or a group class today?”). When people feel in control, they’re less likely to feel helpless about pain. A sense of control can directly combat the helplessness aspect of catastrophizing. Additionally, include activities the person enjoys – enjoyment can boost mood and reduce focus on pain.
Teach active coping skills: As you work with clients, teach them simple techniques to manage pain or anxiety during exercise. For example, if a client notices pain increasing, you might guide them through a short breathing exercise or a quick stretch, rather than immediately stopping in panic. Show them it’s possible to modify movements to be more comfortable (e.g., reducing range of motion, slowing tempo) and that they can resume activity when ready. By actively coping and continuing in a safe manner, clients learn that a spike in pain doesn’t have to derail the whole session. This improves their confidence in handling pain and decreases fearful anticipation in future workouts.
Collaborate for holistic care: If you have clients with high pain catastrophizing or other significant psychological barriers, consider working alongside healthcare providers. Physical therapists, psychologists, or pain specialists can provide cognitive-behavioral therapy (CBT), pain education classes, or other interventions to directly target catastrophizing thoughts. As a fitness professional, you can reinforce those lessons during training sessions. For instance, if a client learned in therapy that “hurt doesn’t equal harm,” you can gently remind them of that motto when they are worried about a normal exercise ache. A team approach ensures the client gets consistent messages and support in both mental and physical aspects of pain management.

Empowerment Through Mindset and Movement

In the journey of managing chronic pain, exercise is a powerful tool and coupling it with a healthy mindset can make it even more effective. While science continues to unravel the details of how exactly psychological factors influence exercise-induced hypoalgesia, the take-home message is clear: your mind and body are connected in pain. By reducing fear, challenging catastrophic thoughts, and celebrating what your body can do, you set the stage for better outcomes. For those with chronic pain, this means you are not helpless – you can take active steps, mentally and physically, to improve your quality of life. And for fitness professionals, your guidance and encouragement can help clients break out of the fear-pain cycle and reclaim the joy of movement.

Bottom line: Maintaining a positive, realistic mindset won’t magically erase all pain, but it can tilt the odds in your favor. Exercise often leads to short-term pain relief, and believing in your ability to move safely and cope with discomfort is part of that healing process. Mindset is one more tool in your toolbox – alongside exercise programs, medical care, and social support – that can empower you to live more fully despite pain. So next time you lace up your shoes for a workout, take a moment to also “train” your thoughts: swap doom-and-gloom predictions with hopeful ones, and remind yourself that with each step or rep, you are building not just physical strength, but also resilience over pain. The science is still catching up, but one thing is certain – a supported mind can help a hurting body heal (pubmed.ncbi.nlm.nih.gov).

References

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Munneke W, Ickmans K, Voogt L. (2020). Do Psychosocial Factors Modify the Hypoalgesic Response to Exercise? A Systematic Review. Pain Practice, 20(7), 784-805. PMID: 32255268
Lazaridou A, Paschali M, Edwards RR, Gilligan C. (2020). Is the Relationship between Physical Activity and Pain Severity Mediated by Pain Catastrophizing? Findings from an Electronic Diary Study in Women with Fibromyalgia. Pain Reports, 5(5), e838. PMID: 32766468
López-Gómez I, Gutiérrez-Rosado T, Torres-Sánchez I, Cabrera-Martos I, Ortiz-Rubio A, Valenza MC. (2023). The influence of walking physical activity on pain and fatigue in fibromyalgia: the mediating role of catastrophizing and disease impact. Clinical Rheumatology, 42(2), 449-458. PMID: 36044172
Patricio A, Baez S, Pardo Y, Valenzuela R, Vargas J, Araya-Quintanilla F, Guzmán-Muñoz E, Beltrán-Sánchez J, Diaz-Castro F, Louw A. (2023). Exercise-induced Hypoalgesia in Chronic Low Back Pain: A Cross-sectional Study. Pain Practice, 23(3), 330-341. PMID: 36461643
Johnsen MB, Landsem IP, Gundersen KT, Haugen T, Iversen V. (2023). Psychosocial Predictors of Exercise-Induced Hypoalgesia. Journal of Pain Research, 16, 369-383. PMID: 36824499

Cole Cruz