Do you agree that how a mother reacts to a child who falls off a swing predicts how quickly they get back on the swing?
What about in cases of chronic pain? Does a caregivers reaction predict the recovery of a patient living with persistent pain? Perhaps!
We, as healthcare providers naturally focus on the patients that are directly in front of us, but when it comes to chronic pain, we should ideally also focus on the ones who care for them, such as parents, spouses or their children.
When someone you love is living with chronic pain, it naturally hurts to see them struggling; you may call this empathy pain.
However, this empathy pain is not just a benign thing in the background, because the people who are around the person living with pain significantly determine their recovery. How a person close you acts around you when you are facing any health issue shapes how you relate to your medical condition.
If a parent believes an activity is dangerous, the child in pain is more likely to fear and avoid that activity. If a wife responds to her husband’s pain experience by being dismissive, his nervous systems register that he is not being heard, so it magnifies the pain intensity to be heard. If a sibling remains supportive, calm, encouraging and validating, the pain experience can become less threatening.
This is not a theory; it is physiology 101 and there is good research to back this up.
“…the effect of family caregivers’ responses to the patient’s pain, is a critical pain source that is suggested to affect coping strategies in patients.”
A common default mode for caregivers is overprotection in the form of doing things for them that they could otherwise do on their own; such as putting on their socks and shoes, doing their laundry, washing their dishes, helping them get off a chair, etc.
This excessive helping and treating them as fragile person leads to them feeling and thinking, “There must be something seriously wrong with me!”
This overprotection sends a message to their nervous system, “You are in danger, so you need to protect yourself.”
With good intentions, some caregivers may take the opposite approach by telling a loved one in chronic pain to just ”push through”. This ‘tough-love’ approach may be often perceived as being dismissive and invalidating which can once again hinder recovery.
So, what is a caregiver to do?
The ideal thing a caregiver can say is, “I believe you, and you can get through this.”
When it comes to chronic pain, how family members and caregivers interact with patients is perhaps more influential to their recovery than the interventions by healthcare providers.
This 2025 review paper looked at the impact of chronic pain on caregivers and not surprisingly found that caregivers of those living with pain also experience significant emotional issues such as despair and anger. Some even blame themselves for being unable to alleviate their loved one’s pain.
“… family may form an underappreciated barrier to achieving optimal pain and mental health outcomes for people with chronic pain” – De La Rosa et al 2025
This 4-minute educational video is specifically aimed at parents who may unintentionally be instilling fear in their child which may be hindering their recovery.