Yoga and the Mind-Body Connection: How Your Mood Influences Pain Perception

You’ve probably experienced pain at some point in your life, yes? Maybe you felt a twinge in your lower back after doing deep backbends in a yoga class. Or maybe a computer-induced wrist condition kept you away from Sun Salutations (Surya Namaskara) for several months. What factors influence your pain perception? If there’s pain, there must surely be a grave physical source, right?

Did you know that your mood, your associations with the circumstances surrounding your pain, and your expectations of greater pain/relief impact how much pain you feel? Our perception of pain isn’t solely dictated by the gravity of its physical source.

Sarah Court, PT, DPT, E-RYT, explains, “Pain is a 100 percent subjective experience, as it is based on everyone’s unique history, upbringing, emotional and mental state, and community of support.”

So, how do your emotions affect your experience of pain? How does the brain process pain? We’ll get a bit more into pain science and how mood affects pain. But first: a story by way of example.

Mood and Pain Perception: The Story of a Stye

On a recent Saturday, I woke up with a stye. It hurt my vanity more than my eye—I’d have to teach my weekend classes without contact lenses and makeup.

By Monday morning, the thing had grown far more than your average stye. And it hurt—a lot. Imagine constant pressure on your eyeball. By Monday afternoon, my whole upper eye was puffy and swollen—and my spirits were inversely low.

Thankfully, the ophthalmologist was able to squeeze me in.

On my drive to his office, I felt considerable discomfort. My eye kept watering, and I had to hold my head at an odd angle to minimize the pressure on my eyeball. I was beset with worry. 

The last time I had a stye this size, it required surgical removal. For me, an outsized stye comes with swollen emotional baggage and a swollen eyelid.

How Our Expectations Affect Pain Perception

Because of my past experiences with the condition, because of my associations with the circumstances and expectations of what might happen, I anticipated greater physical and emotional pain. If you think something will hurt, the event registers higher on the pain scale.

The ophthalmologist diagnosed me with a “garden variety stye” and gave me a treatment plan: 10 days of antibiotics and a fancy microwavable eye patch compress to use three times a day.

Know what? I felt way less physical discomfort on my drive home! Did the eye doctor do anything, any kind of immediate intervention, during my visit that would improve my pain symptoms? Nope.

He just gave me reassurance and a plan of action. Having tools to address the issue eased my worries, and peace of mind decreased the pain considerably.

So, how exactly do emotions affect pain perception?

Pain Science 101: How the Brain Processes Pain

It seems surprising, but pain doesn’t correlate to the severity of a condition. Rather, your brain decides whether you’re in pain and how much.

Dr. Court describes the process: “Your brain and spinal cord (aka your central nervous system [CNS]) receive information from nerves in the body called nociceptors, which signal the CNS that something negative might be going on. The brain then takes that information, compares it to past experiences, considers the person’s current emotional and mental state, and then within all this context, decides if this experience is pain.“

Let’s go back to my stye: My CNS received a message that something was up with my left eyelid. My brain considered past similar experiences (which resulted in surgery) and my current circumstances (I’d have to appear on camera for a photo shoot the following week—yikes!) and decided that, yeah, I was in a lot of pain.

As soon as a medical professional gave me a plan of action, the pain receded.

“It’s well supported in pain research literature,” says Dr. Caitlin Casella, PT, DPT, “that higher levels of worry, fear, and movement/activity avoidance lead to increased perceptions of pain severity and worse outcomes in recovery. One of the best predictors of resolving a painful condition is a patient’s belief that the pain will eventually go away.”

The mind plays a role in how we experience pain. Enter yoga philosophy.

Patanjali on Pain Management: Pratipaksha Bhavana

Sutra 2.33 offers a strategy to lessen pain symptoms by redirecting attention: “Upon being harassed by negative thoughts, one should cultivate counteracting thoughts” (trans. Edwin Bryant). This technique, called pratipaksha bhavana, is a means by which to alter our mood and, hence, our experience of pain. 

This is exactly what I experienced at the ophthalmologist’s office. His advice redirected my thoughts from “This is gonna be really bad. I’m doomed” to “I know what steps to take. I’m on it.” And my pain levels decreased dramatically.

Advice for Yoga Teachers on Talking to Students about Pain

I see evidence that mood affects pain perception regularly when yoga students talk to me about their injuries and conditions. Time and again, the person who’s stressed or depressed about discomfort, the person who’s afraid that movement will exacerbate their symptoms, describes higher levels of pain. How can teachers respond to students’ reports with compassion and, at the same time, encourage an emotional outlook that could help with pain management?

“It is important,” Dr. Court advises, “to maintain a general neutrality in order not to exacerbate the situation. So, if a student comes up before class and says, ‘My knee is really hurting right now, what should I do,’ a good response might be, ‘Oh, I’m sorry to hear that. Let’s figure out ways to participate in a class that feels comfortable for your knee.’ With those words, you are validating their experience, but at the same time, problem-solving how they might take a class and including them in that process gives them more self-efficacy and can decrease fear around the movement for people in pain.”

How Yoga Teachers Can Influence Pain Perception by Building Confidence 

Dr. Casella also emphasizes the role of student empowerment and the importance of not amping up fear responses: “A  potent (and unfortunately underutilized) tool movement professionals have for helping clients manage pain is instilling confidence. This includes affirming that experiencing pain is indeed a bummer while also emphasizing when it is not medically serious and not something that will worsen with activity. Too often, healthcare advice instills fear and encourages movement avoidance, which can be counterproductive.”

Building confidence, rather than steeping in fear and skipping practice, is an application of pratipaksha bhavana—cultivating counteracting, more productive thoughts. Yoga teachers can help students in pain by sharing information about how outlook impacts pain, information that can contextualize their response to the discomfort they’re experiencing and perhaps lessen sensations of pain.

The Intersection of Pain Science and Yoga

When we help students understand the role of mood in pain perception, we integrate the physical yoga practice with its mental/emotional counterpart. When contemporary yoga teachers can call on modern pain science and the yoga tradition’s deeper philosophical teachings, we can truly serve our students holistically.