Welcome to the Pain Free Living podcast with co-host and Therapy coach Clare Elsby.

In this solo episode, she explores a challenge many people face without realising it: the fear of pain and how it can quietly shrink your world.

You’ll hear how one client, after a fall post–hip surgery, became so anxious about “what might happen” that his confidence, mobility, and mood all declined — even though every scan showed he was physically safe.

Clare explains how fear-based pain works, involving your nervous system staying on high alert, so that even normal movement can feel threatening.

You’ll discover why changing unhelpful thoughts (“I will fall”) to gentler “ladder thoughts” (“I might fall”) helps reset the brain, and how small, safe steps rebuild trust in your body. Through gradual exposure and curiosity, her client regained confidence, and the pain eased as his fear lifted.

If you’ve ever stepped back from movement, worried about flare-ups, or felt anxious after an injury, this episode offers simple, practical tools to help you move forward again.

Feel free to share this episode with a friend or family member who would benefit from hearing this advice.

5 Key Takeaways

• Fear of pain is common, and it can amplify symptoms even when scans show nothing is wrong.
• Your internal language (“I will fall”) can fuel anxiety; “ladder thoughts” help bridge back to confidence.
• Avoidance shrinks your world and feeds more fear; gradual exposure helps reverse the cycle.
• Small, safe steps build real evidence that your body is more capable than your anxious mind suggests.
• With the right support, confidence grows, mobility returns, and pain often reduces as fear eases.

Find out more about us and stay connected

😎 Learn more about Bob’s story: https://bit.ly/BobsOsteoStory

🤩 Find out more about Clare’s work: https://www.clareelsby.com/

📰 Sign up for our Pain Free Living newsletter: https://bit.ly/PFL_newsletter_signup

🎙️ Connect with us on socials & podcast platforms: https://linktr.ee/Painfreeliving

Need to Know

This podcast provides general information for educational purposes only. It is not medical advice and should not replace professional assessment, diagnosis, or treatment.

Always seek qualified healthcare advice if you have any concerns about your health before starting exercise or self-care routines.

Hi there.

I'm Clare Elsby.

I'm one of the co hosts of the Pain Free Living podcast with Bob Allen.

And bearing in mind it's Pain Free Living, I thought maybe one of the things I would like to talk about today is the fear of pain.

Because I've actually come across this in practice.

I thought I could probably talk about the effect that this has on us and what we can do to basically make the situation better or help ourselves.

So if I think about the situation that I came across, and I have actually come across it a few times, so this particular situation, there was a chap who'd had a hip operation which went really well, and he was back up and literally walking around within six to eight weeks and feeling quite good about himself.

And he was due to have another hip operation and there was a year's gap between the two hip operations.

And he then had the second hip operation that was a slower recovery, but he was doing quite well, he was fine, all was going well until he was out for the day and had a fall.

And that fall, quite understandably knocked his confidence, but it knocked his confidence to such an effect that he really started to lose his faith, if you like, in his walking and he started to experience pain.

So he went to the GP and he had various tests, went back to consultant and they couldn't actually see anything on any scans that would be causing this pain.

Roll it on a few months and he's not as mobile as he should be and he starts to feel isolated.

One of the things he used to love doing was walking and hiking and he's just not able to do that anymore.

But roll on a couple of months he's out and he actually sees someone else falling over and they actually have a hip fracture, which is a horrendous thing to witness.

Horrendous thing for the individual, but a horrendous thing for this particular person to witness.

And they see that.

And that combined with a lack of confidence from the fall that he'd had previously, meant that he just shut down.

He got to the point where he was actually not able to go outside.

He was walking around at home with a stick and he was experiencing pain again.

He went back to his gp, went back to the consultant, had some more scans and they couldn't find anything.

So he came to the conclusion that actually it must be something that is more affecting his mental health and his physical health.

And that's where I came in.

So it took a couple of sessions for me to get to the bottom of the whole story behind what went on and be able to assure myself that he had had the correct clinical investigation to make sure that it wasn't actual pain that he was experiencing.

And what we decided, or what I decided was actually it was more the fear of pain.

It was the anticipation of falling.

And he was absolutely convinced in his language that every time he went outside and he used these words, every time I go outside, I am going to fall.

So what we did was we worked on that.

We worked on that language, and I questioned that, and I got him to be curious about the fact, well, do you really think every time you're going to go outside, you are going to fall?

And when he thought about it, he thought, well, I might fall.

So I said, well, let's work with might.

And this is what we would call a ladder thought in psychology.

We're not leaping from I am going to fall to I am not going to fall.

That's quite an extreme to go to.

But might is one step up the ladder, and he was prepared to accept that.

So what we did was he promised me that he would go out with his stick.

That's fine.

He would go out with his stick and he would walk to the end of the road.

And by the time we next met, he had done that.

It had been a slow shuffle, but he'd done it.

And I asked him, was there anything.

Did anything happen?

He went, no, it was all fine.

I didn't fall.

So what we did over the next few weeks was we built up evidence that actually he wasn't going to fall.

And we got to the point where he started to walk across the road because he was worried about traffic.

That was the next thing he was worried about falling off the pavement and into traffic.

Traffic.

So we tried Crossroads, we tried going across at lights, and by the time that we finished our sessions or he felt, actually, you know, I'm good now.

I can do this on my own.

He was walking about half a mile a day, which wasn't where he was before, but he didn't have the fear anymore, and the pain had gone.

So that's where I felt actually, I've done my job, and I have actually seen him walking around, and I feel quite proud of that.

So fear of pain is a genuine, genuine thing.

And we can do something about these anxieties.

And that's just one of the things I wanted to bring to people on this podcast, that actually, if we can break it down, if we can question why we feel the way we are, why we feel the way we do get to the bottom of it.

And then what we do is what really is, I guess, exposure therapy is we start very, very small steps, is to start to expose ourselves to the thing that we're afraid of, but in a very safe way, and then we gradually build up the evidence that dispels the original fear.

So that's just another thing for your toolbox.

And it's something that, again, Bob and I feel very passionate about.

On our podcast, Pain Free Living is giving you the tools to live a pain free life.