Pain Catastrophizing: Mechanisms and Clinical Implications

J Pain Res. 2026 May 18:19:592713. doi: 10.2147/JPR.S592713. eCollection 2026.

Abstract

Objective: This study aims to summarize current perspectives on the underlying mechanisms, conceptual frameworks, and potential clinical implications of pain catastrophizing (PC).

Methods: A narrative review approach was employed.

Results: Existing studies suggest that PC may be associated with functional activity in several brain regions, including the anterior cingulate cortex, amygdala, and prefrontal cortex, which are involved in pain perception and emotional regulation. From a psychosocial perspective, catastrophizing has been linked to psychological distress, social support, and behavioral responses to pain. Various interventions, including psychological therapies, pain neuroscience education, exercise-based approaches, and complementary therapies have been explored as potential strategies for addressing PC. However, findings across studies remain heterogeneous.

Discussion: This study integrates current evidence on neurobiological mechanisms and psychosocial models related to PC and discusses their potential clinical implications. By summarizing existing findings and highlighting areas of uncertainty, this work aims to provide a more comprehensive understanding of the multidimensional nature of PC and may inform future research and clinical approaches in chronic pain management.

Keywords: chronic pain; neurobiological mechanisms; pain; pain catastrophizing; psychosocial factors.

Publication types

  • Review