Over the years I have read quite a bit about monitoring pain with the anticipation of improvement. We all do it and expect results from our efforts, whether we are focusing on the physical or psychological. I have just read this whole thread and have a few real time add-ons to the perception of pain. A few weeks ago I went to the local park and used one of those exercise stands. Essentially I sat on a seat (similar to a metal tractor seat), and pushed with my legs. I got a good buzz going on my quads and admit I have been rather slovenly with exercise lately and felt good about exercising again. Later that day pain set in my lower back. I immediately started thinking about my 20 year relationship with my back including my recovery and how I have managed it. I could not think why my back hurt with so little amount of exercise. I hadn’t moved a washing machine like Cricket and it was a happy day and lacked TMS tension. In any event I watched TV with a heating pad knowing from past experience it would be gone the next day. I woke up at three o’clock in the morning, sat up in bed suddenly realized the real cause of my back pain. I had forgotten that I was still in recovery from a fractured sacrum on my tailbone, for I had slipped in the gym last August. I had incurred quite a lot of pain over a six weeks recovery period, visited a surgeon doctor, and had MRI’s ect. I am normally very good at delineating real accident pain vs. TMS pain. I had rubbed my bony ass on that metal seat and made it sore, a very simple explanation. So my thought process about my pain had defaulted to my 20 year old back that I have actually recovered from. I can only imagine the millions and millions of neurological memories and events in my subconscious that took precedence over a recent minor crack in my Sacrum. Additionally to this I have to say during my sacrum Injury period I was completely at ease with it. I have had broken bones before, and I even remember declining pain meds from the doctor. My sacrum injury had in fact taken a back seat to my real fear and trepidation, my neck! It has taken 20 years for me to get my neck checked out properly; I had decided this was the time to do this. I have written about this in other threads, since I did had some anxiety fun while idly recovering. So it seems to me pain perception will default to your worst case scenario, as your pain perception moves to the areas of most importance to you. My perception and concern moved from my real injury, (Sacrum Crack) to my neck (TMS tension) without my knowledge. In 2014 the attached article helped me understand pain perception, especially the sections: “Catastrophizing and Worry” and “Attention and Vigilance”. It also adds to the wonderful insights written by all in this thread. https://academic.oup.com/bja/article/87/1/144/304231 It’s a heavy read, I suggest you save the pdf. that is available.