When Pain Steals Your Focus: Understanding and Managing Distractibility - Part 1

**This blog post just kept writing itself, and once I completed it, it was so long that I decided to break it up into 3 parts. I will post Parts 1 - 3 on consecutive days, starting with today.** 

If you live with chronic pain, you’ve likely experienced this: being in a conversation, trying to read a book or do something you love — and your attention keeps wandering. Sometimes to nothing. It’s just not focused on the task anymore. You might feel guilty or frustrated with yourself for losing focus. But distractibility is not a moral failing. It’s a consequence of how pain hijacks your brain’s attention systems. I struggle with distractions all day, every day, and it means that I’m not always productive or using my time efficiently. And the distraction doesn’t even have to be anything big, because when I’m trying to focus, with all the zillion things in my head that are flinging around, my brain doesn’t know what to focus on, so tries to focus on it all at the same time. This causes a complete overwhelm of my brain, and I become very panicky and anxious and need to leave the situation to find a quieter place. 

I’ve always said I have to distract myself to focus, and it is so true. I love listening to meditations or audiobooks while I do something creative, or doing something creative when hanging out with friends or family, so that my brain is distracted from the pain and I can focus on the good conversation and company. 

When I’m working on a task or chore or something, usually, I’m distracted by something I remember I need to do, or that I was supposed to have done. Sometimes it’s something I need to do right away, which interrupts what I’m doing, other times it’s just something that I don’t want to forget. A tip I read a while ago, said when you are trying to focus on something, and a thought pops into your head. Instead of being distracted by it, I write it down on a pad of paper, so that when I’m finished doing what I am doing, I can attend to the distraction.  

My brain has also experienced so much trauma, that along with the pain, those traumas erode and steal focus as well. And then there’s the dogs and daily household obligations. All of these are impacted by my limited ability to focus. 

So with that all being said, in this post, I will dive deep into:

• The neuroscience of attention and distraction.
  
  
• Why is distractibility so easy when you’re in pain?
  
  
• How excessive distraction affects your daily life, productivity, and self‑esteem.
  
  
• Evidence‑based and practical strategies to reduce the “pull” of distractors.
  
  

Let’s begin with the brain’s battlefield.

1. The Science of Distraction: How Pain Competes for Attention

Distractibility is probably in my top 5 things that I find most frustrating about chronic pain. I can be doing something and my phone will go off, or one of the dogs needs something, it’s time to take my medication, and I lose track of what I’m doing. Or I’m doing something, and I remember I have to do something else, so stop what I’m doing, to do that, and then have a hard time making it back to doing what I was originally doing in the first place. I also juggle bursts of ideas and the things I want to do that pop out of nowhere. For those of us managing persistent pain, the struggle to focus, complete tasks, and maintain a sense of productivity is a common, frustrating, and often self-esteem-eroding reality.

The Science of Distraction: Why Our Brains Stray

At its core, distraction is our brain's natural response to novel or salient stimuli. Our attention system is a finely tuned instrument, constantly scanning our environment for anything that might be a threat, a reward, or simply something new. This is an evolutionary advantage – it kept our ancestors safe from predators and led them to resources. This is not an advantage when you live with chronic pain. There is always a predator lurking around the corner when you live with persistent pain. 

However, in the age of information overload, constant notifications, and, crucially, chronic pain, this system can go into overdrive. When you're in pain, your brain is, understandably, constantly trying to process that pain signal. This takes up a significant amount of cognitive bandwidth. Imagine your brain as a computer with multiple programs running. Pain is a high-priority, resource-intensive program that's always active, leaving less processing power for other applications. This is unfortunately felt immensely. My brain is always “on”, always sending a variety of pain signals, which means I don’t have a lot of bandwidth for even little things.

Neurologically, chronic pain can lead to changes in brain regions involved in attention and executive function, such as the prefrontal cortex. Studies have shown that individuals with chronic pain often exhibit altered brain activity during attention tasks, suggesting a reduced capacity for sustained focus. The default mode network (DMN), a network of brain regions active when our minds wander, also appears to be more active in people with chronic pain. This means your brain is more prone to mind-wandering, pulling you away from the task at hand. I struggle with this so much. It’s like my mind cannot stay in one place. Something is always tugging at it looking for attention. 

This is a major part of my frustration, that when I’m trying to focus, let’s say, writing a blog post, or doing a household chore, I have to work hard at not letting my mind wander to all the unhelpful things running through my brain. I also have to ignore my phone, and make sure the dogs are tended to before starting. I find using my app Forest, a Pomodoro timer, to help, as seeing the timer often helps me maintain focus for the duration of the timer. If I’m doing a household task, I have started listening to music or an audiobook, so that my mind is focused on that instead of all the unhelpful things running through my brain. 

The finite resource: attention as a limited pool

Our brains have a limited capacity for attention and executive control (working memory, inhibition, switching). When you’re healthy and pain-free, you can allocate those cognitive resources to tasks, monitoring, planning, etc. But chronic pain can act like a rogue process consuming part of that capacity. 

• Chronic pain often operates “bottom-up,” meaning it has high salience: it signals threat, discomfort, danger — so it grabs attention automatically.
  
  
• To maintain focus on other things, you need top-down control: consciously directing your attention away from pain toward some external or internal target.
  
  

When pain is strong, bottom-up attention “wins” more often, leaving less cognitive bandwidth for tasks, memory, concentration, planning, etc. When you live with chronic pain as severe as mine is, putting me most days at an 8/10, the pain side is hard to navigate around, because it’s so big, so bold, and so loud. Trying to maintain focus when your brain is being interrupted non-stop with pain signals, is a skill many pain warriors struggle with and out of necessity they have to learn. 

Neural mechanisms: overlap and interference

There is neural overlap between brain areas involved in attention, cognitive control, and pain processing — particularly in the prefrontal and parietal regions. When you engage in a distracting or demanding task, those same brain circuits help suppress (or down-modulate) pain signaling (a phenomenon known as “distraction-induced analgesia”). This means I can focus on what I’m doing enough so that I am thinking about the pain less. This focus re-directs my attention to the task at hand, and not my pain so much. Unfortunately though, once I’m done with that task or activity, and my brain stops having to focus or think about something that hard, my pain awareness opens back up. The downside is that it can only handle so much. Many days my brain cannot maintain much focus and my productivity goes down because the pain is too high. 

But here's the catch: there’s a threshold. If pain becomes too intense, it can overpower the distraction, and your performance on tasks suffers. In experiments with healthy volunteers, cognitive tasks often reduce reported pain, but when pain is stronger, pain can degrade accuracy or speed on the tasks. It’s like trying to balance a tightwire rope act, where less pain can equal more focus, and more pain can mean more distractions. In this instance, my goal should be to manage my pain so that it is below a certain level so that I can physically perform the tasks and activities that I want and need to do. Sometimes this is easier said than done. 

The Myriad Reasons for Pain-Induced Distractibility

Beyond the inherent neurological changes, several factors contribute to heightened distractibility in those with chronic pain:

• The Pain Itself: This is the most obvious culprit. An acute flare-up or even a dull, constant ache demands attention. It's like having a persistent alarm going off in your head that you can't turn off. How can you focus on a spreadsheet when your back is screaming? This is particularly difficult to manage when I’m trying to focus on things like writing, running my business, conversing, household tasks and chores, because it’s like a car alarm that won’t turn off, and your focus shifts to that alarm. 
• Medication Side Effects: Many pain medications, especially opioids and some neuropathic pain drugs, can cause cognitive side effects like "brain fog," drowsiness, and difficulty concentrating. I suffer with severe brain fog due to the pain itself, but I also suffer the side effects of the medications I’m on, that I rely on, as without them I’d not be able to leave my bed or do very much. I’ve come to terms with this and I decided that I will happily give up some of my brain function if it means less pain and allows me to live a life outside of my bed. But that doesn’t mean it makes things easier. 
• Sleep Deprivation: Chronic pain is a notorious sleep disruptor. Poor sleep, in turn, severely impairs cognitive function, including attention, memory, and executive control and increases your pain sensitivity. It's a vicious cycle. I struggle to sleep on a good night, as my sleep is fractured and interrupted by shooting pains that happen when I move in my sleep. So this is one area I need to work on, I just don’t know how, given I can’t control much of what my pain does.
• Emotional Burden: Living with chronic pain often comes with anxiety, depression, and stress. These emotional states are notorious for fragmenting attention, leading to rumination and difficulty focusing on external tasks. This is a really hard thought pattern to break free from because for me the pain is always there triggering some emotion or thought that makes doing what I want to do more difficult. 
• Fear of Movement/Re-injury: For some, the fear of aggravating their pain can lead to hypervigilance, constantly scanning their body for warning signs. This internal scanning is a huge distraction. When you hurt all the time, benign things like giving hugs or bumping into something, doing something mildly physical, or anything that can increase your pain, it can trigger you to hyper-focus on preventing anything that could cause any more pain, no matter how insignificant the task or activity can be. This means avoiding physical contact, or limiting physical contact, avoiding crowds in case you get bumped into, and not doing certain activities, tasks or chores that increase pain. Right now my brain is so saturated with pain, it’s hard to see past that, because my body and brain are on high alert and combined with all my trauma, it means that I miss out on doing things I need to do because they might cause me more pain. 
• Reduced Physical Activity: Lack of physical activity can impact overall brain health and energy levels, further contributing to cognitive sluggishness and reduced focus. This is something I struggle with but have made huge improvements with over the last almost 3 years. I was not able to start a small exercise routine until I began my healing journey from my nervous breakdown in 2023, 15 years after my accidents, and am proud to say that I now exercise regularly with my mother-in-law twice a week, and I try to do mild stretching and exercises on the days I don’t exercise with her. I also try to go for at least 1 walk a day, sometimes I’m able to do two walks. 
• Decision Fatigue: Every day, those with chronic pain make countless decisions related to managing their condition – when to take medication, how much activity is too much, managing appointments, etc. This constant decision-making can deplete cognitive resources, leaving less for other tasks. I feel like I take pills all day, and have reminders set for each of them, and that I’m constantly having to make a decision on whether or not what I want to do is worth the fallout of doing that particular task or activity. 

Distraction is not always equally effective — individual variation matters

The analgesic (pain-reducing) effect of distraction is not uniform. It depends on factors like:

• Pain catastrophizing / negative cognitions: If a person ruminates, magnifies pain, or fears pain, the pull of attention to pain is stronger, making distraction less effective. This is something that I have to work hard at. It’s easy to get caught up in negative thought patterns when you suffer from chronic pain, to ruminate over “what if's" and lost abilities, and those thought patterns impact one’s ability to focus and concentrate on the task or activity.
  
  
• Executive control capacity: People with better inhibitory control or attentional flexibility may be better able to shift focus away from pain. (Though some studies find mixed or weak correlations.) I also find it depends on the activity or task I’m doing. Some tasks, like drawing, painting or doing crafts, help me shift the focus away from the pain easier than others. So does writing, even if I’m writing about chronic pain, it shifts the focus away from that pain, to the positive things I can do.
  
  
• Motivation / engagement: The more meaningful or absorbing a distracting task is, the more effectively it can compete with pain for attention. I find this especially true with the activities and tasks I can easily immerse myself in, or ones that I enjoy doing more than others. I am often finding ways to motivate myself too, so that I can be consistent with my routine and not fall behind on my responsibilities.
  
  

• Type of distraction & its sensory modality: Visual, auditory, or VR tasks may differ in how well they “pull” attention away from internal pain signals. I find organizing, drawing, meditating, doing crafts or something creative, listening to an audiobook, or writing, to be the top activities and tasks that distract me from the pain the most.

...........To be continued - Look for Part 2 tomorrow!..........