Occupational Therapy Strategies for Pain Management
Pain is more than just a physical sensation. It’s an experience shaped by your body, your brain, and even your emotions. At Katherine Jackson Occupational Therapy PLLC, I work with clients every day who are navigating pain, often long after the original injury has healed. One of the most empowering things you can learn on your healing journey is this: pain does not always mean harm, and your brain has an ability to change.
Let’s explore why.
What Is Pain, Really?
Pain is the brain’s way of protecting you. When tissue is damaged, pain signals are sent to the brain to alert you to stop, rest, or seek help. But sometimes, the brain continues to protect even when protection is no longer needed—like a smoke alarm that keeps going off long after the fire is out.
This is where pain neuroscience education becomes a key part of therapy. It helps us understand that pain is not only about what’s happening in the body. It is also deeply connected to how the central nervous system processes and stores experiences.
When Pain Becomes Over-reactive
Pain itself can alter the function of the central nervous system, making a person more sensitive to stimuli—a process known as central sensitization. This occurs when the brain and spinal cord amplify pain signals, even in response to minor or non-painful triggers. As a result, individuals may experience heightened pain (hyperalgesia) or pain from normally non-painful stimuli (allodynia). Central sensitization plays a key role in chronic pain conditions such as fibromyalgia, osteoarthritis, and neuropathic pain, and often persists even after the original injury has healed.
The good news is that change is possible. While central sensitization can feel overwhelming, patients are not powerless. A combination of evidence-based strategies—such as gentle movement and exercise, mindfulness practices, pain neuroscience education, healthy sleep habits, stress reduction, and therapeutic interventions like occupational or physical therapy—can help “retrain” the nervous system. By gradually calming the heightened sensitivity of the CNS, individuals can reclaim a sense of control and begin moving toward improved function and reduced pain. Healing is not always linear, but with support and consistent effort, meaningful change is absolutely within reach.
Neurotags: Your Brain’s Pain “Files”
Think of your brain as a very organized filing cabinet. Every time you have an experience, your nervous system creates a memory pattern—called a neurotag. These neurotags help your brain recall what certain movements or situations felt like. If you’ve experienced pain during a certain activity, like reaching overhead or gripping an object, your brain might store that pain memory as a “pain neurotag.”
Later, when you try that activity again, your brain may trigger the same pain response, even if the tissues are healed. I am NOT saying that it is: “all in your head,” what I am saying is that it is in your nervous system. The good news is: we can change it. Through occupational therapy, we can work together to provide strategies for making a new file in the file drawer. The new file filled with memories of calm, safety and supportive movement.
Emotions and Pain: Why You Might Feel More Than Just Sore
Pain neurotags don’t just involve muscles and joints. They can also store emotional memories. If you felt scared, frustrated, or helpless during your initial injury or recovery, those emotions might get linked to your pain neurotag.
So it’s completely normal to feel emotional during therapy. These feelings are valid—and they’re part of your story. The goal isn’t to avoid them but to gently rewrite the story with new, empowering experiences.
The Pain Stoplight: Listening to Your Body with Mindfulness
A helpful tool we use in therapy is a concept called the Pain Stoplight, which gives us a simple framework for tuning into how your body is responding in the moment. You can learn to self-examine the way you perform tasks in your daily activities and give the pain a label. By labeling the pain, we can become less afraid of momentary increases and work to gradually increase activity tolerance. The stop light is described as follows:
Green Light – Comfortable, no increase in pain. Movement feels safe and steady. This is where we build confidence and strength. If you feel like you are in the green, it means “go,” proceed with your activities and perhaps take on a small challenge.
Yellow Light – Mild discomfort or a small increase in symptoms, but still manageable. You may have performed an activity and experienced pain, but the pain did not persist. This is a zone of growth—but with awareness. We pause, slow down, and reflect. Use caution when performing tasks in the yellow light category, do not push too hard.
Red Light – Sharp pain or emotional distress. This is your brain’s signal to stop and reassess. We don’t push through red lights—we adjust the plan.
Using mindfulness which is the practice of paying attention, on purpose, without judgment, we learn to notice these signals and respond with compassion. Instead of pushing past pain or avoiding all movement, we find the just-right challenge that helps your brain and body feel safe again.
Rewiring Pain Through Meaningful Activity
One of the most powerful tools in occupational therapy is engaging in activities that are meaningful to you. Whether it’s cooking, gardening, being with your pets, or playing music, participating in activities you enjoy can help activate new neurotags. Ones that are positive, purposeful, and not associated with pain.
In therapy, we work together to introduce these activities at a pace that feels right for your nervous system. Each time you move without triggering pain or fear, your brain files away a new memory that says: “This is safe. I can do this.”
You Have the Power to Change
Your nervous system is incredibly adaptable. With education, movement, mindful awareness, and support, you can create new experiences that help calm the pain response and rebuild confidence in your body. While the goal in therapy is not always to make you pain free, the goal is to empower you with improved awareness of triggers and tools to address them.
At Katherine Jackson Occupational Therapy PLLC, I meet each client with compassion and curiosity. Together, we listen to your story, explore your goals, and use science-backed strategies to help you move forward—with less pain and more freedom.
If you’re ready to take the next step in your healing journey, reach out. I’m here to help you reconnect with your body, your strength, and the life you want to live.
Flourish Recovery & Wellness 