Chronic pain doesn’t just affect the body—it can profoundly impact the mind and spirit, trapping patients in a cycle of inactivity that worsens their condition over time. Dr. Gary Sipps of Western Reserve Hospital’s Center for Pain Medicine has spent years studying the intersection of psychology and pain management. In a recent interview, Dr. Sipps shared his insights into breaking the cycle of pain and inactivity, offering actionable strategies for chronic pain patients to reclaim their lives.

The Vicious Cycle of Pain and Inactivity

For many chronic pain patients, the cycle of pain and inactivity is both debilitating and difficult to escape. Pain, by its very nature, signals that something is wrong, prompting individuals instinctively to avoid activities that might worsen their discomfort. However, this well-meaning reaction often leads to unintended consequences.
Dr. Gary Sipps describes this phenomenon succinctly: “Pain is a noxious stimulus that, by definition, people react to. But inactivity leads to atrophy, and even moving at all becomes painful.” This sequence begins with an initial injury or chronic condition that causes pain, leading patients to limit their physical activity. Over time, the body adapts to this reduced movement by weakening muscles, stiffening joints, and lowering overall endurance. These physical changes, in turn, exacerbate the pain, making even minor movements feel daunting or impossible.

The psychological impact of chronic pain compounds the issue. Fear of pain, known as kinesiophobia, often prevents patients from attempting even mild activity, as they worry it could lead to further injury or harm. “The more they sit and are inactive, the worse their condition becomes,” Dr. Sipps explains. “It’s a vicious cycle.” This fear can grow into avoidance behaviors that extend beyond physical activity, leading patients to withdraw from social interactions, hobbies, and work, further diminishing their quality of life.

Inactivity doesn’t just amplify pain—it also affects overall health. Prolonged immobility can lead to secondary issues such as weight gain, cardiovascular problems, and mental health challenges like anxiety and depression. The more entrenched these issues become, the harder it is for patients to envision a way out of the cycle. As Dr. Sipps notes, “People often become phobic of movement because it might increase their experience of pain, although it’s not causing damage. It’s a vicious cycle: the more inactive they are, the more difficult even minimal movement becomes.”

Another factor contributing to this cycle is the passive mindset that chronic pain can create. Patients may become reliant on medications or other treatments that don’t require active participation, such as surgeries or injections. While these interventions certainly have a major role in pain management, they often fail to address the underlying inactivity that fuels the cycle. “Patients often become passive, relying on medications or avoiding movement altogether,” Dr. Sipps observes. This passivity can prevent individuals from exploring strategies that would help them regain strength, mobility, and confidence.

Breaking free from this cycle requires a fundamental shift in perspective. Instead of viewing pain as an insurmountable barrier, patients need to reframe it as a challenge to overcome. The first step is understanding that some discomfort during movement is normal and doesn’t necessarily indicate harm. As Dr. Sipps points out, “Pain is not always a sign of damaging tissue. It can simply be an indication that you’re doing something different.” This distinction is crucial in helping patients develop the courage to take the first steps toward activity.

This cycle isn’t just about physical pain—it’s also deeply tied to emotional and psychological factors. The experience of living with chronic pain can erode hope, leaving patients feeling trapped in their circumstances. Over time, this hopelessness can lead to a loss of motivation, making the prospect of change feel impossible. “Pain management isn’t just about reducing discomfort,” Dr. Sipps emphasizes. “It’s about helping patients see a path forward—one where they are in control and capable of making meaningful changes.”

By addressing both the physical and psychological aspects of pain, patients can begin to disrupt the cycle and move toward a more active, fulfilling life. This requires a comprehensive, patient-centered approach, which is where behavioral health techniques can make a transformative difference.

Behavioral Health Techniques to Break the Cycle

Breaking the cycle of pain and inactivity requires more than just a medical intervention; it calls for a holistic approach that addresses both the physical and psychological aspects of chronic pain. Behavioral health techniques are at the forefront of this strategy, helping patients not only reframe their understanding of pain but also develop practical tools to regain control over their lives. Dr. Gary Sipps emphasizes that these strategies are not a one-size-fits-all solution but instead tailored to meet each patient’s unique needs. “We help patients set goals and treat pain as the stressor it is,” he explains. “Cognitive interventions like reframing allow patients to see pain as something they can contend with rather than something that defines them.”

Here are key behavioral health strategies that can help break the cycle of pain and inactivity:

1. Cognitive Reframing: Changing the Perception of Pain

One of the foundational techniques in behavioral health is cognitive reframing, which helps patients shift their mindset about pain. Instead of viewing pain as a debilitating barrier, patients learn to see it as a challenge that can be managed. “Cognitive interventions almost always involve the person’s perception of pain,” Dr. Sipps explains. “We encourage patients to objectify the pain, to see it as something they’re dealing with rather than something that’s a part of them.”
For example, a patient who wakes up with a headache might typically think, “Today is going to be terrible because of my headache.” Cognitive reframing shifts this thought to something like, “I have a headache now, but I can still find ways to cope and make the most of my day.” This subtle but powerful shift in perspective can help patients approach pain with a problem-solving mindset rather than one of defeat.

2. Gradual Goal Setting: Small Steps Toward Activity

When dealing with chronic pain, the idea of returning to a full, active lifestyle can feel overwhelming. Behavioral health professionals work with patients to set realistic, incremental goals that help them regain confidence in their ability to move and function. Dr. Sipps highlights this approach: “It’s about helping patients increase their physical activity and become proactive instead of reactive to pain.”

For instance, a patient who has been mostly sedentary might start with simple activities like standing up and stretching for a few minutes each hour or taking a short walk around the house. As their strength and mobility improve, these goals can gradually expand to include more challenging activities, such as walking longer distances or engaging in light exercise. This method allows patients to experience small, consistent wins, which build momentum and motivation over time.

3. Stress Management: Reducing the Psychological Burden

Stress often exacerbates the experience of pain, creating a cycle where the two feed off each other. Stress management techniques, such as mindfulness meditation, deep breathing exercises, and progressive muscle relaxation, can help patients break this cycle. “Stress management strategies can help patients respond to pain more effectively and reduce their reactivity to it,” Dr. Sipps explains.

Mindfulness practices, in particular, encourage patients to observe their pain without judgment, reducing the emotional intensity associated with it. By cultivating a sense of calm and control, patients are better equipped to manage their pain and engage in physical activity.

4. Biofeedback and Wearable Technology: Encouraging Engagement

Technology has become a valuable tool in behavioral health, offering patients new ways to monitor and manage their activity levels. Devices like smartwatches and fitness trackers provide real-time feedback on metrics such as steps taken, heart rate, and even reminders to move. Dr. Sipps describes these tools as an extension of traditional biofeedback, which helps patients gain awareness of their body’s responses and make adjustments in real-time. “Biofeedback and wearables allow patients to set goals and monitor their activity, reducing stress and increasing their flexibility,” he says.
For example, a smartwatch might alert a patient who has been sitting for too long to get up and stretch, reinforcing the importance of regular movement. Over time, these small adjustments can lead to significant improvements in physical health and pain management.

5. Building Coping Skills: Tools for Long-Term Success

Effective pain management isn’t just about addressing the pain in the moment; it’s about equipping patients with coping skills they can use in their daily lives. Behavioral health interventions teach patients techniques to handle flare-ups, such as using distraction techniques, relaxation exercises, or guided imagery. These tools help patients regain a sense of control and reduce the fear associated with pain.

Dr. Sipps emphasizes the importance of integrating these skills into everyday life, not just during therapy sessions. “The main thing is to take it with them and to practice and apply it, not just to be able to discuss it in the office,” he says. This ongoing practice helps patients build resilience and maintain progress over the long term.

6. Encouraging Empowerment Through Active Participation

Perhaps the most transformative aspect of behavioral health is its focus on empowering patients to take an active role in their care. Dr. Sipps advocates for patients to be “51% involved” in their own pain management journey. “The providers are there to assist, but the patient must take charge,” he explains. This mindset shifts patients from being passive recipients of care to active participants, fostering a sense of ownership and independence.

By combining these behavioral health strategies, patients can break free from the cycle of pain and inactivity, gradually rebuilding their strength, mobility, and confidence. As Dr. Sipps notes, “Pain management isn’t just about reducing discomfort—it’s about helping patients see a path forward, one where they are in control and capable of making meaningful changes.”

This comprehensive approach doesn’t just address the symptoms of pain; it empowers patients to reclaim their lives.

Overcoming Barriers to Activity

One of the greatest challenges in implementing these strategies is addressing the stigma surrounding psychological approaches to pain management. Many patients mistakenly believe that seeking behavioral health treatment implies their pain isn’t real. Dr. Sipps notes, “For some people, going to behavioral health is commensurate with saying they’re imagining the pain or that they’re crazy.”
Healthcare providers play a crucial role in overcoming these misconceptions. By educating patients about the biopsychosocial model of pain management—a holistic approach that considers biological, psychological, and social factors—they can help patients see the value of psychological interventions.
Another barrier is patient passivity. Chronic pain often leads individuals to adopt a reactive mindset, waiting for treatments to “fix” their pain. “Patients often become passive, relying on medications or avoiding movement altogether,” Dr. Sipps observes. Encouraging patients to take an active role in their care is essential. 

Conclusion: Empower Yourself to Take Control

Living with chronic pain can feel overwhelming, but it doesn’t have to dictate your life. By embracing proactive strategies and seeking support from a multidisciplinary team, you can break free from the cycle of pain and inactivity.
If you or a loved one is struggling with chronic pain, contact the compassionate team at Western Reserve Hospital’s Center for Pain Medicine. With expert guidance and a holistic approach, we’re here to help you regain your mobility, confidence, and quality of life. Take the first step toward a brighter future—reach out to us today.