Perspectives on Pain: A Narrative Review of Pain Beliefs, Coping, and Clinical Implications

Pain beliefs and coping strategies are often linked to treatment outcomes across various pain conditions, yet their roles are often examined in isolation across specific conditions. This narrative review synthesizes evidence across neuropathic, nociplastic, and nociceptive pain to examine how pain-related beliefs shape coping behaviors, treatment adherence, and clinical outcomes. Guided by the Common Sense Model of Illness, we integrate findings from neurobiological, psychological, and clinical literature to demonstrate how negative pain beliefs, such as fear-avoidance, pain catastrophizing, and lower self-efficacy, have been linked to heightened pain perception, maladaptive coping, reduced adherence, and poorer functional recovery. In contrast, positive pain beliefs emphasizing resilience and self-efficacy are often linked to adaptive coping, improved engagement in care, and more favorable outcomes, in part through modulation of prefrontal, limbic, and descending pain regulatory systems. This review synthesizes findings across diverse patient populations and conditions, with an emphasis on the differences in the various effects of pain beliefs and coping strategies. Across conditions, consistent patterns emerge in which belief-driven processes influence both behavioral and neurophysiological responses to pain. We further highlight gaps in current clinical assessment, particularly the underrepresentation of multidimensional belief constructs in routine care, and discuss implications for multidisciplinary, belief-informed interventions. Targeting pain beliefs through cognitive-behavioral strategies, patient education, and individualized care models represents a critical opportunity to improve adherence, reduce disability, and enhance long-term recovery.