Author(s) :

Elisha Kang.

Volume/Issue :

Abstract :

Psychological factors have become increasingly recognized as critical components in the experience of chronic pain, alongside its physical mechanisms. Although existing literature highlights the links between stress, memory networks, and pain, the precise neurobiological and cognitive pathways driving stress-induced pain amplification remain unclear. To address this critical gap, this comprehensive review evaluates how these interconnected systems modulate subjective pain perception, while assessing the efficacy of integrated psychological interventions. Centrally, stress activates the hypothalamic-pituitaryadrenal (HPA) axis, releasing cortisol that facilitates the consolidation and retrieval of negative, painrelated memories via the amygdala-hippocampal complex. This neurological loop drives cognitively mediated pain amplification through anticipatory processing, pain imagery, and negative expectations. Regarding clinical applications, systematic evidence indicates that psychological therapies – primarily cognitive behavioral therapy (CBT) and mindfulness – alleviate functional disability and improve coping strategies rather than consistently reducing physical pain intensity. Because therapeutic outcomes vary significantly based on the intervention type, patient demographics, and clinical timing, treatment models must evolve into precision-based, collaborative care plans. Finally, this review highlights the critical need for advanced neuroimaging and biomarker developments to successfully distinguish psychologically driven pain amplification from progressive tissue damage, paving the way for targeted, precision pain management.