If it's in our mind, why do certain movements and postures cause the problems?

So I'm doing therapy the other day and I realize I've been relaxing on the couch with my legs brought up under me and it's all a weird position, I even mentioned "whoa, look how I'm sitting" and dropped my legs down.

For the next couple days, patellar femoral pain.

That's just one example. Sometimes I'll be doing a thing in a weird position for a while and it will cause all sorts of problems the next day. If this is in our mind, why do specific behaviors product the pain?

 

Even when pain has a mind–body component, specific behaviours or postures can still elicit pain because the nervous system blends physical input, previous learning, emotional response, and conscious attention—all influencing how and when pain emerges.

Physical pain after specific postures or behaviours—like sitting with legs tucked under, for example—can often be traced to both mind and body factors, especially in chronic pain or sensitised states. The mechanics of a posture may physically stress a joint, muscle, or nerve, but whether and how this produces pain can depend heavily on the current state of the nervous system, emotional context, and habits of attention and interpretation.

Mind–Body Interaction in Pain

• Attention and Interpretation: If one notices or feels concern about an unusual posture, attention may focus on that body part. Heightened attention, expectation of problems, or prior experience with pain can increase the nervous system’s sensitivity to signals from that region, amplifying discomfort.
  
• Emotional State and Stress: Emotional factors such as anxiety, frustration, or worry increase pain sensitivity and can prolong pain after minor physical triggers. Catastrophic thinking (e.g., “What if this causes real damage?”) creates a cycle where pain becomes more intrusive and persistent.
  
• Conditioning and Fear-Avoidance: The brain can link certain positions or activities with threat, especially after a pain episode. The fear-avoidance model suggests that anticipating pain or harm from a posture increases hypervigilance, reinforces avoidance behaviors, and maintains pain.

Mechanical and Protective Responses

• Biomechanical Stress: Prolonged or awkward positions that compress or twist joints may stress tissues and trigger pain, even without injury. For people with heightened nervous system sensitivity (e.g., those with fibromyalgia or chronic musculoskeletal pain), minor biomechanical stressors can provoke outsized discomfort.
  
• Body's Protective Response: In chronic pain, the nervous system often shifts to “overprotective mode,” interpreting neutral or mildly stressful positions as dangerous and signaling pain to prompt movement or caution.

Why Specific Behaviours Cause Pain

• Behaviors that place unfamiliar stress on body tissues can activate pain pathways both physically (from pressure or stretch) and psychologically (from awareness, expectation, or anxiety).
  
• Chronic pain states “prime” the nervous system to respond more easily and from minor triggers with real pain, often due to learned associations and the influence of attention, worry, and emotional context.

 

I know we gotta search for the triggers and so on, but to be honest I find it very frustrating trying to figure it out. There are so many variables during the day, and a lot of things might trigger some level of danger in our unconscious mind.

I prefer to work with what is there in the moment. For example, you were sitting strange, but since there was no pain, as soon as I'd notice it I'd remain in this position and feel the different sensation.

Peter Levine tells to gently do the motion your body feels like it. I love this approach.

 

Consider the trigger is simply that your mind has been trained to dislike many sensations eg. of any variety of emotions and one is the feeling of being anxious or feeling fear. It illicits the fear of fear. This is the type of "trigger" you can notice a few times and then realize that you're going to have a first reaction but can take a breath and change your response - which is exactly what you've been doing. I recognized that constantly being fearful and having to be "on alert" at all times is DEEPLY enraging.

 

Bascially in your mind, that position is setting off your danger alarm in your brain.

That first reaction is so hard to stop when symptoms flare. But I'm working on what my second reaction is and sometimes I do great-sometimes I don't!

 

This is in Buddhism called "the second arrow of suffering", the unnecessary extra pain we cause to ourselves by giving meaning to the first one.

That's one of the reasons I step away from the conversation about whether the brain knows what is doing. It is what it is.

 

I had to think a bunch to answer this one. I do realize my anxious is much more about my emotional reaction to the symptoms than the symptoms themselves. And it's hard to avoid it just by doing the work, since the symptoms keep blasting in our ears. They're just the messenger though, that unfortunately end up being a strong distraction. It's like having to change the tire of a moving car.

But we know we gotta break through the symptoms in order to get where the work has to be done. Well, a quick passage from Michael Singer's The Untethered Soul:

"One of the essential requirements for true spiritual growth and deep personal transformation is coming to peace with pain. No expansion or evolution can take place without change, and periods of change are not always comfortable. Change involves challenging what is familiar to us and daring to question our traditional needs for safety, comfort and control. This is often perceived as a painful experience."

 

The entire book of the Unteathered Soul is about dealing with the fear of all fears.

 

If you were as flexible as you were when you were a kid then any posture wouldn't bother you so much, over time however via stress and other emotional factors certain parts of your body have contracted which then makes certain positions uncomfortable or hurt if you stay like that for a long time. The problem is that most of us dont realise it until the pain really ramps up.

 

So the pain is caused by a physical reason?

 

There may be something that is physically ‘off’ but in the majority of chronic pain cases I don’t think that’s the underlying cause of the pain.

if we are to fully buy in to this TMS theory (I do!) then it is well within the brain’s capabilities to pick up on something that is physically off but not worthy of pain and still generate pain in the area. If the brain is trying to distract us from something then it has to be convincing. Postural issues are also in the zeitgeist as are things like RSI. We’ve been told all these issues annd subsequent pain are rooted in purely physical changes.

we also have to accept that our nervous systems are just heightened. So we cross our legs because there’s a weird sensation, we can give that sensation way too much attention, then our terrified brain fixates on it, and we fixate on the fixation and thus we create a loop and nervous system can start reacting to normal sensations and interpret them as pain.

as we get further along in this journey I think we start to attune with the fact that we are much very capable of making the sensations worse by how much attention we give them. I can very much spiral and fixated on an area of my body that is physically off (my horrible posture-I’m too tall lol and have bad habits, my severed vas deferens from a vasectomy) and create the sensations that I have largely overcome. From a neuroplastixity standpoint it tracks because those pathways are likely going to stick around for awhile even when we have done work to ‘dim’ them.