Chronic pain affects more than 50 million adults in the United States,1 making it one of the most common and costly health problems today. It’s not just about the discomfort experienced every day — given enough time, pain reshapes how you move, think, and live.
What’s worse is that many people assume the pain itself limits activity, but new research2 shows that there is a light at the end of the tunnel. How you think about pain determines whether you stay active or withdraw from life. In other words, how you perceive pain and work through it can positively affect your life and keep you moving despite the setbacks.3
Pain Resilience Shapes How You Move Through Chronic Pain
In a study published in PLOS ONE, researchers sought to answer this question — why do some people with chronic pain stay active while others become sedentary, even when their pain levels are the same? To start, they investigated how two psychological factors, pain resilience and fear of movement, influence the relationship between pain and physical activity.
Their goal was to understand whether these traits act as links that explain why some people maintain movement despite discomfort, while others limit their activity and lose function over time.4
The study focused on adults living with long-term musculoskeletal pain, which includes conditions like chronic back, neck, shoulder, or joint pain. Using questionnaires, the team measured pain severity, fear of movement, physical activity, and pain resilience. By analyzing these variables, they discovered that resilience, not fear, was the key factor keeping people active.
• Pain resilience refers to your capacity to adapt and function even when pain is present — It’s not about ignoring pain or pretending it doesn’t hurt. It’s about how quickly you regain balance after pain flares up, how you interpret the experience, and whether you still pursue meaningful activity.
Participants with higher pain resilience remained more physically active, even with significant pain. In contrast, those who were fearful of pain-related movement were less active, but that fear alone didn’t explain the whole story. When resilience was added to the equation, it overshadowed fear’s influence.
• Resilience acts like a mental shock absorber — When you’re resilient, you recognize discomfort, pace yourself, and still move forward. The researchers showed that resilience partially mediated between pain and activity levels. Fear of movement, by comparison, had a weaker effect once resilience was considered.
• Analyzing the differences in pain resilience between men and women — Men showed higher resilience and greater activity levels compared to women, even after adjusting for pain severity and age. This doesn’t mean resilience is based on sex — it suggests that social factors, coping styles, and self-efficacy differ between men and women.
• Frailty was linked to lower activity levels — However, resilience buffered that effect. Even among frail participants, those who scored higher on resilience measures stayed more mobile. This means cultivating resilience could preserve independence and delay disability, even for older adults or those with multiple pain sites.
• The passage of time plays a key role in developing resilience — Participants who had lived with pain for years often developed coping patterns — some adaptive, some not. Those who maintained active lifestyles tended to report that movement helped them feel more in control of their pain.
In contrast, those who had withdrawn from activity described a deteriorating feedback loop — less movement led to weaker muscles, greater stiffness, and more perceived pain.
The results show that the difference between staying stuck and staying strong isn’t the pain you’re currently experiencing — it’s how you face it. The more you build your ability to recover from pain episodes and stay active despite discomfort, the more your body rewards you with strength, mobility, and confidence.
What Defines Pain Resilience?
In another study published in the Iranian Journal of Nursing and Midwifery Research, researchers explored what resilience looks like for people living with long-term pain. Rather than measuring resilience through surveys or numbers, the team asked people directly about their lived experiences. Their goal was to identify the traits, habits, and mindsets that help people continue functioning and maintain purpose even when pain remains part of everyday life.5
The methodology focused on adults who had experienced chronic pain for years. Through in-depth interviews, the researchers found a set of common themes that separated those who endured from those who truly adapted.
• Five main components of resilience emerged from the interviews — These are emotional self-regulation, psychological flexibility, self-care behaviors, religion and spirituality, and internal strengths and competencies. Each one represents a different way of maintaining balance, and together they form a blueprint anyone with chronic pain could learn from.
• Emotional self-regulation — This means controlling your reactions instead of letting pain control you. When discomfort spikes, resilient people pause, breathe, and shift their focus. They acknowledge the pain without surrendering to it. This ability to manage emotions acts like a built-in pressure release valve, preventing anxiety and frustration from amplifying physical suffering.
• Psychological flexibility — This trait describes your capacity to adapt your mindset when reality doesn’t match your expectations. Instead of fixating on how things used to be, flexible thinkers adjust their goals to what’s possible now. The key idea is movement toward meaning — staying connected to what matters most rather than obsessing over what’s been lost. That mental shift rewires how you experience pain, making it less of a personal failure and more of a challenge to navigate.
• Self-care — This doesn’t mean indulging yourself in vices that only temporarily make you feel good. It means being deliberate about choices that maintain physical and emotional stability:6
“Self-care in this study refers to individuals with CP [chronic pain] adopting a variety of strategies — physical, psychological, medical, and complementary therapies — on their own. Additionally, they tailor their lifestyles to better manage pain and enhance their ability to cope with it,” the researchers reported.
“By taking care of oneself (i.e., doing activities according to one’s skill and ability to maintain and improve one’s physical and mental health), the patient can help improve his/her resilience against pain.”
• Religion and spirituality — Prayer, meditation, and gratitude practices gave participants structure during uncertainty. They reported that spiritual grounding improved their emotional endurance, reduced feelings of isolation, and gave them a framework for acceptance.
• Internal resources — This last category tied all the others together. These include optimism, persistence, problem-solving skills, and self-confidence. People who believed in their ability to adapt were the ones who did so successfully. They saw themselves not as victims of pain but as active participants in their own recovery process:7
“The participants of the present study indicated that the ability to better tolerate pain depends on individual capabilities and the application of past experiences. People’s willingness to learn is closely linked to a person’s resilience …
[C]haracteristics such as independence, decision-making power, trust, forgiveness, determination, and strength play an essential role in resilience against pain.”
• Don’t dismiss the power of family and friends — One observation in this study was how resilient individuals balanced independence and support. They accepted help without feeling helpless. As noted by one participant in the study:8
“Having strong social relationships and communication skills can help a person’s resilience. Usually, people with a social and communication network around them can withstand problems and pain better.”
Tips to Build Your Mental Resilience
Based on the findings discussed above, your perception of pain is important to management. However, it’s not as easy as flipping a switch and you’re on your way to better pain management. You’ll need to build your resilience, and it starts with these strategies:
• Increase your carbohydrate intake — As neuroscientist Raffael Kalisch noted in the documentary “Mental Health and Resilience — The Secrets of Inner Strength,” maintaining good physical health plays a role in how resilient you are under stress. In his own words, “The key to resilience is staying healthy even when faced with life’s burdens.”
That said, I recommend that you focus on healthy carbohydrates as your main source of energy. When the body runs on this fuel, your cellular health begins to repair itself. While healthy fat also serves as fuel, carbohydrates create less reactive oxygen species (ROS) in your mitochondria. But again, the emphasis is on healthy carbohydrates — not refined carbohydrates from ultraprocessed foods. In addition, this strategy helps lower your cortisol, which, when elevated, accelerates aging and stress.
Most adults require around 250 grams of healthy carbohydrates a day. Start with white rice and whole fruit, as they give your body glucose without overwhelming your gut. If your digestive system is compromised, ease into carbohydrate-rich foods carefully. Fiber and starch feed both beneficial and harmful gut bacteria, so it would be wise to go slow. For a more in-depth understanding of this topic, read “Are Mood Disorders Actually Metabolic Diseases Rooted in Insulin Resistance?“
• Train your brain to be optimistic — According to Dr. Sue Varma, psychiatrist and author of “Practical Optimism: The Art, Science, and Practice of Exceptional Well-Being,” optimism can be learned just like any other habit. She explains that even if you aren’t naturally inclined to expect good outcomes, you can train your mind to reframe challenges:9
“Even if you were not born with this natural disposition to anticipate favorable outcomes and see the glass as half full, there are skills that you can learn. Begin by noticing how you deal with uncertainty. Do you tend to worry? Assume the worst? Try to reframe the thought in an objective manner. ‘Is there a silver lining? Is this a problem to be solved or a truth to be accepted?'”
When you’re faced with a challenge, picture the best possible outcome in detail, then map out the steps required to get there. This approach keeps you proactive and resilient. But optimism isn’t only about problem-solving — it’s about creating meaning. Volunteering or helping others provides purpose and perspective. If your schedule is packed, consider ways to make your work more fulfilling, such as initiating group activities or adding creative projects that align with your interests.
Another effective way to boost optimism is by learning something new. Take up a skill or hobby you’ve been curious about — a sport, a musical instrument, or a new language. New experiences stimulate your brain, crowding out negative thought loops and giving you something to look forward to. As Dr. Varma puts it, “It’s a toolset, it’s a mindset. I have to practice it every day in my mind.”
• Make walking part of your daily routine — Research published in GeroScience10 discovered that walking isn’t only an exercise that makes you sweat — it’s a powerful antiaging tool that enhances both longevity and metabolic health. Their findings showed that consistent walking improves sleep, cognition, and cardiovascular function, while lowering the risk of Type 2 diabetes. In another study,11 regular exercise also helps manage chronic pain, highlighting the importance of moving your body.
So, what exercise can you start with? The simplest answer is walking. According to a 2023 analysis,12 taking around 8,000 a day dramatically reduces your overall risk of death and heart disease. Cardiologist Dr. James O’Keefe, the author of the study (whom I’ve also interviewed), emphasizes that consistency matters to get the biggest benefits:
“Clearly, more is better. You get the big gains going from sedentary lifestyles — 2,000 to 3,000 steps a day — up to 7,000 or 8,000. [Here] you have this very steep reduction in mortality, improvement in survival. It continues to about 12,000 steps a day. Most of the studies show that it plateaus at 12,000.”
• Prioritize quality sleep — Resilience depends heavily on quality sleep. When you’re deprived of rest, your mind makes it harder to handle stress or trauma. One study13 investigated this link among 127 college students. The team found that poor sleep directly increased anxiety symptoms, weakening resilience and impairing the ability to stay optimistic.
Interestingly, students who already had higher resilience levels were able to buffer these effects, adjusting their mindset more easily even when sleep quality declined.
If you struggle with rest, small environmental changes can make a big difference. Keep your room as dark as possible using blackout curtains or use a fitted sleep mask. Eliminate sources of electromagnetic fields (EMFs) by turning off your Wi-Fi router and keeping electronic devices, including alarm clocks, out of your bedroom. For more detailed strategies, read “Top 33 Tips to Optimize Your Sleep Routine.”
Frequently Asked Questions (FAQs) About Pain Resilience
Q: What is the main takeaway about pain resilience and management of chronic pain?
A: How you perceive pain influences your ability to stay active more than the pain itself. Research revealed that pain resilience — the ability to recover and keep moving despite discomfort — is the strongest factor determining physical activity levels. Building resilience helps you maintain mobility, independence, and emotional balance even when pain doesn’t fully go away.
Q: On a deeper level, what does pain resilience mean?
A: Pain resilience means your ability to adapt, function, and stay engaged in daily life even while experiencing pain. It’s not about ignoring pain but about how you respond to it. Resilient people manage emotions effectively, pace their activity, and continue pursuing meaningful goals. In contrast, fear of movement leads to inactivity, weakness, and worsening pain over time.
Q: What habits and traits help build pain resilience?
A: According to research, five traits strengthen resilience — self-regulation, psychological flexibility, self-care behaviors, religion and spirituality, and internal strengths and competencies. These traits teach you how to handle pain calmly, adjust goals realistically, and maintain a sense of purpose. Social support from friends and family also reinforces resilience by reducing stress and loneliness.
Q: How can lifestyle choices improve resilience and reduce pain?
A: Several practical habits improve resilience and overall well-being:
• Increase healthy carbohydrates to 250 grams — A healthy fuel source reduces stress hormones like cortisol and supports mitochondrial energy production.
• Train your brain toward optimism — Positive thinking, volunteering, and learning new skills build mental flexibility and provide joy.
• Walk regularly — Walking enhances longevity, cognitive function, and mitochondrial health while lowering the risk of chronic disease.
• Prioritize sleep — Deep, uninterrupted sleep restores emotional balance and reduces anxiety, strengthening mental resilience.
Q: Why is focusing on resilience better than trying to eliminate pain completely?
A: Because chronic pain often doesn’t disappear entirely, chasing total pain elimination can create frustration and dependency. Focusing on resilience instead puts control back in your hands. When you strengthen your body and mind’s ability to adapt, pain becomes less dominant in your life. Over time, this approach leads to more energy, greater mobility, and a renewed confidence in taking control of your health.
