The first thing to know about pain is that it’s all in uour head – but that doesn’t mean pain isn’t real! ALL pain is real and is an experience that’s created by your brain when your brain considers all the information at hand and decides that you are in danger and in need of protection. Pain is one of your body’s protection systems that keeps you out of danger. Pain hurts to get you to change what you’re doing or to keep you from repeating something dangerous.
The second thing to know about pain is that damage in your body is only one of the pieces of information your brain uses to decide if you need protecting. It’s an important bit of information, but whether you have an experience of pain or not does not depend on damage in your body.
Why is it important to know about how pain works? Because that’s another important piece of information for your brain in deciding whether you need protecting or not. It has actually been shown (repeatedly) that the more you know about how pain works, the less it hurts! That is amazing! But there’s a good reason for it.
Your brain takes in all kinds of information, both consciously and unconsciously, like:
- Things you see (for example, an x-ray)
- Things you say (for example, “I’m getting old, it’s only normal that everything hurts!” vs. “There’s light at the end of the tunnel!”)
- How you feel (for example, hopeless vs. appreciative of the small joys in life)
- Things you do (for example, not leaving the house at all vs. gentle movement)
- Things you believe (for example, “My father had a bad back and I’m just like him” vs. “If my brain decides I’m in danger, it will protect me with an experience of pain”)
Your brain weighs all this information, and if it has more evidence of “danger” than “safety,” you will experience pain. If there is more evidence of “safety,” you won’t. (There are other strange possibilities, too. For example: if your brain decides that protecting you means not giving you an experience of pain, like if you step on a nail barefoot but you suddenly see a deadly snake next to your foot. You might not feel pain in that case. This is because damage in your tissues is not the only information the brain uses to decide if it should protect you with pain.)
When you have pain and you don’t know why, that tends to increase fear, as well as evidence for your brain that you are in danger. Modern pain research show that when you learn about how pain works, pain is less frightening. So the more you learn, the less evidence of danger your brain has.
How pain happens
The most common way that the experience of pain happens is called “nociception.”
You have sensors throughout your brain and body called “nociceptors.” (“Noci” means danger, so these are “danger detectors.”) Nociceptors detect changes in 1) pressure, 2) temperature and 3) chemicals that may mean danger to your body. When there is enough of a pressure, temperature or chemical stimulus (for example, a hammer on your finger, a flame or chemicals released by cells in your body that cause swelling), these sensors open up and allow electrically charged molecules (ions) to enter the cell. The more ions that enter the cell, the more excited the cell gets. When it gets excited enough, it sends a danger message to the next nerve cell in your spinal cord. If that cell receives enough of a danger message, or many danger messages, it, too, gets excited and sends off a danger message to the brain. The brain receives that information, along with lots of other information. Then your brain puts all the information in the balance and decides if you need protecting with an experience of pain. Many different parts of your brain participate in making that interpretation, for example parts of the brain involved in sensation, movement, memory, emotion and cognition.
It’s important to keep in mind that nociception is the most common way a pain experience starts, but it’s not the only way, and it also might not result in pain.
Next time I’ll write more about the different factors that give your brain evidence of “danger” or “safety” in you, because the key to reducing your pain is finding out why your brain has concluded that you are in danger and in need of protection.
Meanwhile, here are two practices you can do to increase evidence of “safety” in you! (It’s half-way down the page. Sorry, I don’t know how to link that specifically!)
Congratulations for starting down the path toward reducing your pain, regardless of the cause!
Explain Pain, 2nd Edition; Moseley and Butler. Noigroup Publications. 2013.
Explain Pain Supercharged – The Clinician’s Manual; Moseley and Butler. Noigroup Publications. 2017.