Does Focusing on Pain Make It Worse?

This is a really interesting topic that I'm sure you will resonate with. Pain and symptoms can be influenced by both attention and distraction. It depends on how you pay attention and how you use distraction.

After a fresh injury, it's completely normal for your attention to keep going back to the sore area. We want to avoid further harm to these tissues. When pain becomes chronic or persistent, constantly checking and monitoring it can turn up the "volume" of your pain experience like your 3 year old grabbing the remote and turning the tv up a lot louder than you'd like!

And weirdly the opposite can also be true - being properly absorbed in something else can turn it down. And there's newer research suggesting that calm, curious attention may work very differently from anxious checking.

If that all sounds contradictory and unclear, that's because it kind of is - so let's dive into the nuance behind this all because it is important.

Have you ever noticed that pain is one of the most distracting things that can happen to you? Your focus gets pulled back to it again and again.

That's one of pain's major functions and it's by design. Pain is there to alert your conscious attention to something that might need looking after. If I've just pulled my hamstring or cracked a rib, it's a normal, healthy & self-protective behaviour for my attention to keep being drawn to that area. As the tissues heal and the pain eases, that drawing of your conscious attention usually fades away on its own.

Your nervous system is taking in a constant stream of information from your body and the world around you: stretch, light touch, heat, cold, vibration, position, pressure. Most of it never reaches your conscious awareness. A lot of it is filtered and dealt with lower down, at the level of the spinal cord.

Let's use an analogy to understand this. Think of your local post office. Thousands of letters and parcels arrive every day, all different shapes, sizes and colours (different sensory signals), from different houses (different parts of your body), addressed to different places. They're sorted, filtered and dealt with locally. Only some get sent on to the national sorting centre: the brain, where conscious attention lives.

Focusing your attention on a body part is like sticking a priority label on every parcel from that address. Every part of the chain from the local to the national post office then pays much more attention and care to those letters. In your body, that effectively results in much more information from that area reaching your conscious brain than normally would happen.

Try this - let's experiment for a moment

Sit comfortably and close your eyes. Bring all of your attention to one hand. Notice its position, where it's touching something, how warm or cool it is, any tingling or pressure. Stay with it for 30 seconds.

Now shift your attention to your left foot. Suddenly you become much more aware of that foot, than you were when focusing on your hand.

Nothing changed in your hand or your foot. What changed was how much of the information from those areas was permitted to pass through this sophisticated filtering system to reach the conscious parts of your brain.

Now imagine that hand or foot is a part of you that has hurt for months or years. Your scans may not show an injury that explains it, and a lot of people with persistent pain find themselves in this exact scenario where they hurt a lot, but there is not as much evidence of harm to support why they hurt.

If your nervous system has already learned to see the painful area as a place of potential for harm, sending more sensory inputs straight to the conscious part of the brain from this area could make it more likely that the level or amount of pain increases. What I've seen in clinic repeatedly is that the more fixated someone becomes on a painful area, the more painful it tends to get. Constantly checking in on, prodding at and monitoring a painful area can be a little like pouring petrol on a fire and wondering why the flames aren't going out.

There's research behind this too. In a 2012 study, researchers scanned people's spinal cords while they felt a heat stimulus. When people focused on the pain, activity in the spinal cord's pain pathways went up. When they were absorbed in a demanding task, they were given that same heat stimulus and spinal cord activity went down, and so did how much it hurt.¹

Pain is built to grab attention, so actively tuning your attention elsewhere can feel counterintuitive because it means you are working against a very natural instinct. Turns out that context matters!

From my own personal experience and from the many, many clients I've met in clinic, this can get a bit more complicated. For some people the checking in on what's happening in their body goes above and beyond the painful area. They find themselves watching their body closely in general, often worrying about what each new sensation might mean, and searching for answers. I certainly did this a lot when I was struggling with pain and it definitely was a contributing factor in my pain journey. You could call this health anxiety.

And when it comes to pain it can easily turn into a vicious cycle where pain makes you worry more about your body, the worry keeps your attention on your body, and that attention can continue to amplify your pain.² Breaking that cycle can often be an important step in improving pain.

Research backs up part of this too: high levels of health anxiety tend to lend itself to a poorer outcome for people with pain, and unfortunately, living with chronic pain can itself raise health anxiety.³

Question: Have you noticed your pain reduce or even disappear when you're fully absorbed in something? I hear versions of this all the time:

"It's weird. When I'm out walking with my friend and we're chatting away, I barely feel my knee at all."

People tell me the same about a busy day at work, being stuck into a creative project or when they're playing with their kids. They feel much less or no pain at all and then they sit down on the couch in the evening to wind down and the pain is back.

Distraction may help us explain why that happens.

In that same 2012 study, part of the pain relief from distraction came from the body's own pain-relieving chemistry, the endogenous opioids. "Endogenous" means that it's made inside your body. These are your own built-in painkillers and one of the ways you switch on the production of these opioids is when you are fully and completely distracted by something.¹

The catch is that the distraction has to actually distract you. Trying to "not think about pain" while doing something for the sake of it doesn't count. The more you get lost in something, the better it tends to work.

It is a bit more complex than just fully distracting yourself though. Despite what I've written above - when researchers pooled the studies of distraction in people with chronic pain, they didn't find a clear effect on pain.⁴ There weren't many studies, so that doesn't prove distraction is useless. It does show that what works in a lab setting with healthy volunteers doesn't directly carry over to persistent pain. Research is obviously important, but it cannot be the be all and end all for something as unique and personal as a pain experience. If distraction works for you and helps you with the burden of pain then my advice is to leverage that as needed whilst recognising that it is simply another tool in your toolbelt that can help you manage your symptoms while you work on the bigger picture.

This is where some shiny new research gets interesting. In a 2026 study, researchers caused a small patch of inflammation on people's arms with a skin prick. When people focused on the sensations from that spot, the swelling and redness were smaller than when they focused on a screen instead.⁵ The twist: while focusing, people felt more itching and burning. Attention turned the sensation up, but the body's actual inflammatory responses were calmer or reduced. That's kind of both the same as pouring petrol on the fire, but also having a different physiological effect at the same time.

That study was in healthy people over 20 minutes, not people with persistent pain, so that may not carry over to people experiencing persistent pain at all. It does however fit with something else.

A more recently developed approach to treating chronic back pain asks people to pay attention to their pain directly and on purpose, with a sense of curiosity and safety, instead of scanning their lower back for "danger". In a 2022 trial of this method, about two in three people who had that therapy were pain-free or nearly pain-free afterwards, far more than the comparison groups.⁶

There's an older study here that also surprised me. Researchers followed 81 people with chronic pain through a physio session. Some were asked to pay attention to their physical sensations, some to distract themselves, and some to do the session as usual. You might expect attention to be worst for the people with high health anxiety. It was the opposite. For them, paying attention to their sensations led to less anxiety and less pain than distraction did, at least in the short term.⁷

I think that names something important. When you can actually observe a symptom, name it, and recognise that it is NOT a sign of a major health event, injury or trauma, that piece of attention does something useful. Paired with making sense of what you're feeling, it's a way to find out that there is more safety present than your nervous system predicted. In essence, sometimes attention can be a way of gathering evidence of safety. And that is something I speak about ALL the time with my clients.

It all depends on whether you can actually make sense of what you notice. Checking for reassurance ("phew, it's fine") gives a bit of short term relief that likely fades, and then you need to check again tomorrow. That keeps the "needing to check in with your body" loop going. Noticing in order to understand ("I know what this is, it isn't dangerous, and I don't need to keep checking it") has much more potential to change what you expect (or what your nervous system may predict) next time and I think the need to keep checking gets smaller and smaller over time this way.

So attention itself may not be the problem. How you use it might be. Anxious checking, prodding and searching for danger is one thing. Calmly noticing what's there, and making sense of it, may be something quite different.

• If you're not sure whether you've injured yourself, get it checked first. If there's a fresh injury, it makes sense for your attention to stay on it while it heals.
• Notice the checking habit. Prodding, testing, scanning and searching can become automatic. Catching it is the first step.
• Find distractions that truly absorb you. For some people it's music, a podcast or a conversation. For others it's a puzzle, a hobby, or getting stuck into work. Experiment, and make it something you enjoy.
• When you do pay attention, try curiosity instead of alarm. What does it actually feel like? Does it change? Notice it without testing it.

If your pain eases a lot when you're absorbed in something, that tells you your nervous system is likely having a big say in how much it hurts. It's a strong hint that pain doesn't always equate to damage in your tissues and that the area you're worried about may be less fragile than it feels.

If that makes sense to you, it can be a real turning point. If it doesn't yet, that's OK too. Use this as a springboard to find one distraction that genuinely helps you, and start there.

This article is general education, not a diagnosis or a substitute for care from your GP or healthcare team. If your pain is new, getting worse, or comes with symptoms that worry you, please get it checked.

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