Options for those suffering from chronic pain include surgery, medications and various therapies. But what about those people that lack a physiological cause for their pain? What happens when there is no explanation for why their body is turning against them?

The brain can send out pain signals in the absence of all physical dysfunction. When the reason for pain is evident, the root of it can be treated, but when there is no physical abnormality, one must look elsewhere for the root cause of pain.

According to a study in the The Journal of the International Association for the Study of Pain, the root may be fear. In this study, tests were administered to determine individual anxiety levels. The Anxiety Sensitivity Index questionnaire was given to measure the subjects’ levels of anxiety about certain physical sensations, and the Fear of Pain questionnaire was given to measure fear levels for different types of physical pain. Participants were then subjected to varying levels of pain, applied in a manner that would not cause harm. Imaging was completed on the subjects’ brains while the pain was inflicted.

The study revealed a high correlation between the Fear of Pain questionnaire and the right lateral orbital frontal cortex. This is an area of the brain that when activated may reflect attempts by fearful individuals to evaluate and/or regulate responses to pain. There was also a high correlation between the Anxiety Sensitivity Index and the medial prefrontal gyrus, which is the area of the brain that focuses on what is wrong with the body. Researchers concluded that the perception of pain varies widely between individuals and that these differences may be due to differing fears and anxieties around their pain.

Stephanie Moniuk, of Knockout Wellness, in Woburn, has based her business as a mind-body connection coach on finding ways to unwind the connections between fear and pain within the brain. “I teach clients how to turn fear and pain into power,” says Moniuk. “I like to tell clients I’m like a computer programmer, and their mind is the computer operating system. The problem is that there is a bug in their system. That bug is the fear and pain programs that are constantly running in the background.”

The hardest part for pain specialist Moniuk is helping clients understand that the term mind-body does not mean that it’s all in their head. The mind-body terminology can be frustrating for pain patients, as it is often misinterpreted. Pain that stems from the mind doesn’t make it any less painful; nor does it mean that the pain isn’t real. It does, however, mean that the pain can be harder to understand and treat.

Mind-body connection coaching uses various tools to create new connections in the brain that break the fear patterns that elicit pain, including guided imagery and graded exposure therapy.

In the guided imagery exercises, the client is asked to recall a situation that made them uncomfortable. As they recall, they focus on what type of physical sensation comes with the emotional discomfort and where it is located within their body. Once the fear is given a form, it can be released through a variety of exercises.

Another exercise to reduce fear is graded exposure. This therapy is like a vaccination; giving the body and mind a small and innocuous dose of the fear and slowly and gradually upping the dosage until the original fear is gone.

Mind-body connection coaching can empower individuals that have lost faith in their body’s ability to regulate pain. Moniuk says that the results she has witnessed have been inspiring. “Less fear, less pain, more confidence, more self-awareness…making that connection between the mind and the body is transformational for people,” she maintains.