When Caroline Beall, DO, a family and sports medicine physician in Michigan, was 16, she felt a deep, burning ache radiate across her lower back during volleyball practice. Osteopathic manipulation helped her feel better at first, but pain became a familiar part of her life for the next two decades.

One weekend in 2019, when she was 36, Beall doubled over with a shooting pain down her leg. Unable to move, she had to take time off work. What followed was a long, winding medical journey, often recognizable to those with chronic pain: MRIs, x-rays, physical therapy, and medications. Diagnosed with a disc herniation and nerve irritation, she got only temporary relief from epidural injections. 

One day, driving home from work, Beall pulled over in debilitating pain. “Every time I cried, it hurt more because I was moving,” she said. “I was so scared. I needed help with everything. Lying down hurt. Standing hurt. I could not find a comfortable position. Medicine never did anything for it; it didn’t touch it.”

Beall’s story isn’t rare. Chronic pain is the most common reason adults seek medical care in the United States: 24.3% of US adults — more than 60 million people — experience chronic pain every day or nearly every day, according to the CDC. Another 8.5% live with high-impact chronic pain that frequently limits work or daily functioning.

Most clinicians acknowledge that the brain influences the pain experience. As pain persists, the central nervous system becomes increasingly involved, explained Dan Clauw, MD, director of the Chronic Pain and Fatigue Research Center at the University of Michigan. Over time, the brain becomes more reactive and sensitive — changes that can maintain pain even after the original injury or inflammation has resolved.

However, current pain treatments still tend to focus narrowly on symptoms and anatomy, said Laura Payne, PhD, director of the Clinical and Translational Pain Research Laboratory at McLean Hospital in Massachusetts, leaving some patients to struggle with hidden gaps in pain care.

Medscape Medical News spoke with doctors who have experienced chronic pain about what pain care often gets wrong and how becoming a pain patient has fundamentally changed the way they practice medicine.

When the Physician Is the Pain Patient

Large-scale data on chronic pain among physicians are limited. One small study of about 500 healthcare workers in Spain found that 43.7% reported chronic musculoskeletal pain. Given the realities of medical practice — long hours, high stress, poor sleep, and little time for self-care — it’s understandable, and even likely, that physicians experience chronic pain at elevated rates, said Ajay Wasan, MD, director of the Center for Innovation in Pain Care at the University of Pittsburgh. 

Chronic pain has a way of humbling even the most experienced clinicians. For many, it becomes time-consuming and exhausting — a crash course in self-advocacy, compassion, and open-mindedness.

The summer before she started residency in 2010, Massachusetts-based pediatrician Heather Finlay-Morreale, MD, developed severe foot pain. Some days, she would stuff three shoe inserts into her shoes just to get through long hours on her feet. “Having any kind of illness or disability in medical training was not really tolerated,” she said. “I kind of hid it; I powered through.”

Then, one morning in 2018, Finlay-Morreale woke up with excruciating pain down the right side of her body. She was diagnosed with zoster sine herpete, which evolved into herpetic neuralgia. She still has flares to this day, triggered by twisting, bending, or even changes in the weather. 

“It’s sometimes called the suicide disease because of how painful it is,” she said.

Finlay-Morreale continued to practice, relying on lidocaine patches and a TENS unit. “I tried everything,” she said, including medications. “High-dose naproxen actually gave me temporary kidney failure.” She adapted to her pain at work. “I learned how to look in kids’ ears without twisting or bending. I had to get very creative with how I moved my body just to do my job.”

After later diagnoses of Sjögren syndrome and myasthenia gravis, Finlay-Morreale made the difficult decision to leave medicine in 2022. Her physical limitations made it nearly impossible to work. 

Navigating pain care, many physician-patients have encountered stigma and suspicion. “I’ve had providers who don't believe me because my pain is not on an MRI or an x-ray,” said Finlay-Morreale, who often uses a wheelchair and worries about how new clinicians will perceive her as a patient. She recalled expressing despair around her pain to one physician who outright dismissed her.

The stigma may persist because chronic pain is often poorly addressed in medical school and residency. Pain is also treated across many specialties, widening gaps in training and treatment approaches. 

“We don't really have a group of subspecialists trained in listening to people’s experiences and trying to get people nonpharmacologic approaches,” said Clauw, who added that when it comes to chronic pain, the “care model in the United States is really sort of broken.”

Re-thinking Chronic Pain Management

Failed treatments for pain are commonplace in healthcare. Surgery for low back pain or injections — which have poor success rates — are commonly performed and widely reimbursed. Prescribing practices have also shifted sharply in response to the opioid epidemic, and many physicians have moved away from opioids, which are not first-line treatments for chronic pain. Some feel “nervous” continuing opioids even for low-risk patients, while others may prescribe more opioids when nonopioid options fail.

Doctors who live with chronic pain have experienced the frustration of ineffective treatments firsthand. Finlay-Morreale underwent nerve blocks, Botox, ablations — “procedure after procedure” — in an effort to control her pain. For years, Beall similarly pursued injections and other interventions with little lasting relief. 

Today, Beall is certain that her pain was not structural in nature but rather mind-body mediated: the idea that emotional pain can create and further physician pain. Yet, despite seeing multiple pain specialists throughout her journey, Beall was never told about this mind-body connection.

The concept that chronic pain can be centrally mediated and occur without ongoing structural damage can be difficult to accept. “If you’re experiencing pain in your ankle, it feels impossible that something isn’t wrong with the ankle,” Payne said. “It goes against our intuition.”

In a 2024 study of 222 patients with chronic low back pain, nearly 98% had abnormalities on MRI. But when researchers examined symptom patterns, stressors, and variability in pain, 88% of patients were found to have nonstructural pain. Neuroimaging studies also show that physical injury and emotional injury activate overlapping brain circuits on fMRI.

Howard Schubiner, MD, a co-author of the 2024 study and author of the forthcoming book Unlearn Your Pain: The Science of Recovering from Chronic Pain, Fatigue, Anxiety, and Depression, experienced recurrent episodes of torticollis during his thirties and forties. “I always told myself I’d slept wrong. In retrospect, stress was building up in my life,” he said.

At the time, Schubiner was teaching, caring for patients, conducting research, running programs, serving on committees, managing residencies, and raising a family. “It was like a pressure valve,” he said. “My brain just said, ‘Whoa, this is too much.’ But the brain doesn’t speak English. It doesn’t say, ‘Howard, you’re putting too much pressure on yourself.’”

Martina Ziegenbein, MD, a rheumatologist on Cape Cod, traces her chronic pain back to childhood hypermobility and scoliosis. In adulthood, she was diagnosed with fibromyalgia and later rheumatoid arthritis. While her symptoms have waxed and waned, they worsened during a period of professional upheaval, when she left her job to start a private practice. “That’s when the financial insecurity and anxiety really set in,” she said. “My practice didn’t take off right away, and I had to take on another job.”

The pain affected her emotionally as well. “The biggest impact was my irritability,” she said. “I would raise my voice. I would scream. That’s how my pain got the worst of me.”

That overlap is common, Wasan explained. Many brain regions involved in pain processing also regulate mood. “It’s normal for chronic pain to affect sleep, mood, anxiety, and depression,” he said. Over time with chronic pain, existential questions — what pain means, how long it will last, how much it will limit your life — can become deeply entwined with the pain itself.

Beall says that in the depths of her pain, fear became a defining feature of her experience. She was constantly worried about triggering or worsening symptoms — something experts say can amplify pain over time as the brain begins to associate normal movement or daily activities with danger. 

Ziegenbein describes a similar psychological toll. She says she “created an identity around pain” beginning in childhood, thinking things like “my back is not strong enough for that” when faced with physical tasks. Over time, those beliefs shaped how she moved through the world, limiting activity and reinforcing a sense of physical vulnerability.

In his book, Schubiner recounts the story of a physician who lived with severe chronic pain for years. With no clear physical explanation for his symptoms, repeated failed treatments, and clinicians unsure how to help, the physician ultimately died by suicide.

A Mind-Body Approach to Chronic Pain Treatment

Experts now recommend a coordinated, multimodal approach to chronic pain: diagnosis that considers musculoskeletal, neurologic, and behavioral contributors; nonopioid medications when appropriate; physical and occupational therapy; and integrative treatments such as tai chi or acupuncture. 

Mental health care is a key component, including therapies such as pain reprocessing therapy (PRT) and emotional awareness and expression therapy (EAET), which address pain by retraining the brain and processing emotional stressors. 

“Addressing thoughts, emotions, and behaviors together, along with gentle rehabilitation and fear-avoidance therapies, can be extremely effective,” said Wasan. 

After learning about PRT and EAET in 2022, Beall began to notice that her pain flared during periods of feeling out of control, a pattern she recognized across her upbringing, work, and relationships. 

Through a diligent practice of nervous system regulation, self-care, and mind-body work, Beall is largely pain-free today, though symptoms can resurface during stressful moments. 

For Finlay-Morreale, seeing a therapist who specializes in acceptance and commitment therapy (ACT) was “tremendously” helpful, even if it didn’t eliminate her pain. “She somehow transformed how I was interacting with the pain,” she said. 

Over time, she’s reached what she describes as an equilibrium. “I accept that the pain will come and go,” she said. “When it flares, I don’t spiral into thinking it will last forever.”

Schubiner’s pain resolved as he began practicing and teaching mindfulness meditation. He stresses that re-thinking pain care demands rigorous engagement with the evidence. “That means being skeptical and willing to follow the data — even when it challenges what we were taught.”

The Link Between Patient and Practice

Many of the physicians Medscape Medical News spoke with detailed the ways in which a chronic pain journey has shaped their medical practice.

“I became much more of an advocate for patients, and certainly much more understanding,” said Finlay-Morreale. “I have a lot of sympathy for people who have pain which doesn't always show on an MRI or an x-ray.”

Ziegenbein echoes that shift. “I think I have more compassion for women who come to me and tell me they are in pain. Nobody believes them,” she said, adding that she feels better equipped to support patients living with pain.

Ultimately, experts say healing from chronic pain requires humanity. Compassionate care remains critical, and listening closely can provide essential clues. Practicing that compassion, these physician-patients say, has also helped them to extend it toward themselves.

Progress, too, requires openness to new approaches. “It is very humbling to consider that things may be different from what we've learned,” Payne said. “We're all in this process of learning and understanding and growing, and I think that’s what the goal of medicine is.”