Is chronic pain fair? Does anyone deserve it? Research shows that when a person feels as though their pain is unfair they tend not do recover as well from their injury. Perceived injustice, the “Why me?” pattern of thought, can lead to a cascade of negative outcomes, including more pain, disability and medication use, including strong opioid analgesics. Our team sought to understand why people who perceive their pain as unfair are more likely to have prescriptions for opioid analgesics. As it turns out, the more people perceive their pain as unfair, the more likely they are to engage in pain behaviors. Pain behaviors are a form of communication to express suffering through actions such as rubbing, limping, grimacing, etc. As a result, physicians may perceive more suffering and in turn, prescribe opioid analgesics. Given the opioid crisis and dangers associated with opioid prescription, it is critical for physicians to be aware of behaviors before considering prescribing opioids for chronic pain.