What is causing your pain?
We’ve already ruled out serious medical causes of your pain – this is good news! This workbook will help you identify some of the contributing factors to your pain. Most people understand that damaged tissue can cause pain. For example, a broken bone, strained muscle or sprained ligament. But what a lot of people don’t know is that these tissues heal over time. Muscles heal in 3-4weeks, bone in 6-8 weeks and ligaments, tendons and discs heal in 12-18 months. So, if you’ve had your pain for longer than this, it is very likely not caused by any injury to the tissues. If you’ve had an MRI, CT, X-Ray or Ultrasound to try and find the cause of your pain, you may have been told that you have arthritis, or degeneration, or a disc bulge of some kind, or one of many other findings commonly seen on scans such as these. Did you know that according to current guidelines from around the world, all these findings occur very commonly in pain-free people and are almost certainly not the cause of pain? So, what might be the cause of your pain? A great deal of research over the last 20 years has shown that sometimes, through no fault of your own, your nervous system can become hypersensitive. Essentially your pain system turns up the volume and over-reacts to things that normally would not cause you pain. We are still learning about this phenomenon, but there are several factors we know that can contribute to pain sensitivity, that have nothing to do with the tissues of the body. For example, you may have noticed that your pain is worse when you are stressed or have slept poorly. There are also things that can decrease pain, by building resilience. Like getting a goodnight’s sleep. The particular factors that affect each person, are quite individual. This worksheet will help you identify any factors that may be contributing to your pain.
Name
First Name
Last Name
Email
example@example.com
Stressors and other factors that can contribute to pain
Pain stress
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10
You have full control over your pain (or you have no pain at all)
You have no control over your pain. It is unpredictable, constant, and severe
1 is You have full control over your pain (or you have no pain at all), 10 is You have no control over your pain. It is unpredictable, constant, and severe
Work stress
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1
2
3
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5
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8
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10
You have no work stress. Your work situation is ideal
You have severe stress or anxiety at your current work or lack of work
1 is You have no work stress. Your work situation is ideal, 10 is You have severe stress or anxiety at your current work or lack of work
Family Stress
*
1
2
3
4
5
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8
9
10
You have no family stress. Everything is beautiful
You are dealing with a high level of family stress from spouse, kids or in-laws
1 is You have no family stress. Everything is beautiful, 10 is You are dealing with a high level of family stress from spouse, kids or in-laws
Friends /Social Stress
1
2
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10
You have a great social life, with close friends you see often
You don’t have a social life at all, or there is serious conflict with your friends
1 is You have a great social life, with close friends you see often, 10 is You don’t have a social life at all, or there is serious conflict with your friends
Pain Focus /Behaviour
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1
2
3
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5
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10
You don’t really ever focus on your pain, you just get on with life
You constantly check in with your symptoms, trying to protect your back. You also massage and stretch yourself, wear a brace or support, or obsess about finding the cause of your symptoms
1 is You don’t really ever focus on your pain, you just get on with life, 10 is You constantly check in with your symptoms, trying to protect your back. You also massage and stretch yourself, wear a brace or support, or obsess about finding the cause of your symptoms
Fear of NotRecovering
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1
2
3
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5
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10
You are 100% confident you will make a full recovery
You are extremely fearful and worried about never getting better
1 is You are 100% confident you will make a full recovery, 10 is You are extremely fearful and worried about never getting better
Low Mood /Sadness
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1
2
3
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10
You rarely feel sad or down, and it quickly passes
You have been diagnosed with depression, and feel it is not well controlled
1 is You rarely feel sad or down, and it quickly passes, 10 is You have been diagnosed with depression, and feel it is not well controlled
Worry over Scan Results
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1
2
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10
You are not at all concerned about your X-ray or MRI
You are extremely worried about your X-ray or MRI results and have searchedthe internet to learn more, making things worse
1 is You are not at all concerned about your X-ray or MRI, 10 is You are extremely worried about your X-ray or MRI results and have searchedthe internet to learn more, making things worse
Other Health Issues
*
1
2
3
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5
6
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10
You have no other health problems aside from your current pain condition
You have other health issues such as allergies, high blood pressure, digestiveissues, migraine, weight gain, etc.
1 is You have no other health problems aside from your current pain condition, 10 is You have other health issues such as allergies, high blood pressure, digestiveissues, migraine, weight gain, etc.
Total Stressor Score (add up all scores)
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Healthy behaviours & support can build resilience & reduce pain
Exercise
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1
2
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8
9
10
You are currently not involved in any physical activity
You do at least 1 hour of moderate physical activity every day
1 is You are currently not involved in any physical activity, 10 is You do at least 1 hour of moderate physical activity every day
Family
*
1
2
3
4
5
6
7
8
9
10
You have no family support and feel no one cares about your situation
You have a great supportive family who are always there for you
1 is You have no family support and feel no one cares about your situation, 10 is You have a great supportive family who are always there for you
Work
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1
2
3
4
5
6
7
8
9
10
You hate your job, your employer and your co-workers
You absolutely love your job, your employer and all your co-workers
1 is You hate your job, your employer and your co-workers, 10 is You absolutely love your job, your employer and all your co-workers
Diet, Smoking, Alcohols
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1
2
3
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10
You skip meals, eat fast food for every day, smoke and regularly drink more than 3 servings of alcohol
You eat fresh fruits and vegetables every day, don’t smoke and occasionallydrink one serving of alcohol
1 is You skip meals, eat fast food for every day, smoke and regularly drink more than 3 servings of alcohol, 10 is You eat fresh fruits and vegetables every day, don’t smoke and occasionallydrink one serving of alcohol
Therapists
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1
2
3
4
5
6
7
8
9
10
You are extremely dissatisfied with your therapists and doctors
You are extremely happy with your doctors and therapists; they’re caring,knowledgeable and have your best interest in mind
1 is You are extremely dissatisfied with your therapists and doctors, 10 is You are extremely happy with your doctors and therapists; they’re caring,knowledgeable and have your best interest in mind
Time spent Outdoors
*
1
2
3
4
5
6
7
8
9
10
You are basically always indoors, either in your home or at work
You spend at least one hour a day outdoors with nature
1 is You are basically always indoors, either in your home or at work, 10 is You spend at least one hour a day outdoors with nature
Relaxation
*
1
2
3
4
5
6
7
8
9
10
You don’t put any time aside for relaxation; your mind chatters constantly
You consciously put at least one hour aside every day for relaxation
1 is You don’t put any time aside for relaxation; your mind chatters constantly, 10 is You consciously put at least one hour aside every day for relaxation
Sleep
*
1
2
3
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5
6
7
8
9
10
You do not sleep well; your sleep is interrupted, and you wake feeling tired
You get 7-8 hours of sleep every night and wake refreshed every morning
1 is You do not sleep well; your sleep is interrupted, and you wake feeling tired, 10 is You get 7-8 hours of sleep every night and wake refreshed every morning
Fun
*
1
2
3
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5
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10
You don’t put any time aside for fun activities and there is nothing that youconsider as fun or enjoyable anymore
You don’t put any time aside for fun activities and there is nothing that youconsider as fun or enjoyable anymore
1 is You don’t put any time aside for fun activities and there is nothing that youconsider as fun or enjoyable anymore, 10 is You don’t put any time aside for fun activities and there is nothing that youconsider as fun or enjoyable anymore
Total Healthy Behaviour and Social Support Score (add up all scores)
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Make a change
The total score for your stressors ,
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The total score for your healthy behaviours .
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If there was one stressor that you feel both:
• Is important to change• You are able to change. What would that be?
Likewise, if there were one healthy behaviour you feel it is both:
• Important to change• You are able to changeWhat would it be, and how much change would be enough for now?
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