Your Brain and Pain

Your brain and pain. What is this the nature of this relationship? To start, pain is complicated.

Louder for the people in the back: pain is complicated! I hope that we might have answers to some of the questions you may have about the relationship between your brain and the pain you’re in.

Try answering some of these true or false questions to get you started (adapted from The Pain Truth test from aptei.ca):

1. Pain always means that there is something injured or damaged in the body.
2. When part of your body is injured, special pain receptors convey the pain message to your brain.
3. Chronic pain means that an injury hasn’t healed properly.
4. Pain is an alarm system that warns the body of actual or perceived danger.
5. The brain decides when you will experience pain.
6. It is possible to have pain and not know about it.
7. All pain is real.
8. Thoughts and fears can cause or increase pain.

The first three statements are false, the rest are true. 

How did you do? Did any of those surprise you? Let’s dive a little deeper to understand what it all means.

The Definition of pain

In order to really understand what we’re talking about, we need to get clear on the definition of pain. Pain is

“an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage” 

Pain is your body’s alarm system for actual or perceived danger. We will keep this definition in mind as we discuss things below.

Your Brain’s Role in your Pain

What does it mean when we say “pain is produced by the brain”? Does that mean it’s all in your head, and isn’t real? Absolutely not! All pain is real and valid.

Let’s explore how your brain plays a pivotal role in your experience of pain.

When you get a paper cut on your fingertip, where do you feel the pain? Where the cut is? Of course! So, the pain must be originating from there, right? That’s where it gets a bit tricky.

The sensory receptors in your finger are not specialized ‘pain’ receptors. In response to negative stimulus, a variety of different sensory receptors work together to send all sorts of signals up to your brain. This process is called nociception. The brain makes the final decision to either ring the alarm or not. Ringing the alarm sends signals down from the brain as an output to different parts of your body, which results in the multi-faceted experience of pain. 

You experience a painful sensation where the cut happens, and you may experience a sudden surge of emotions. You then move your finger away from the paper without realizing it. A rush of adrenaline courses through your body.

These are all examples of responses that your body can go through when the brain decides to ring the pain alarm.

Let’s use some other examples to illustrate how your brain’s control of your experience of pain can result in unique scenarios:

Imagine you are being chased by an angry bear in a forest and you trip over a root. As you’re running away, scraping your knee. Do you notice the scrape? Probably not, since you’re more focused on running for your life. Your brain decided that ringing the pain alarm was not as important as using up its energy to help you survive. You will probably notice the scrape later when you are safe, and you can now spare some attention to the aches and pains in your body.

Another unique example is phantom limb pain. Individuals who have had amputations can still experience a phenomenon where they still feel pain in their amputated limb, even though it is no longer there. This just goes to show that you can experience pain in the absence of actual damage to your body (remember the definition of pain above?).

Take a moment now to pat yourself on the head and thank your brain for all its wonderful mysteries that we’re still trying to figure out.

What can Physiotherapy do to help with my pain?

When you’ve had an injury, the first thing you will probably notice is pain. This pain may lead you to seeking the help of a physiotherapist. Worry not, friends! We’ve got you.

The good news is all tissues can heal. It takes approximately 3 months for any tissue injury to heal, including fractures. At that point, there is usually no more ‘damage’ in your body.

But what if you’ve had back pain for years? Or a nagging knee injury from years ago that still hurts?

What if the pain just won’t go away?

Chronic Pain

This is where physiotherapists have been known to shine (think, sports injury or after a surgery)!

Once we know your body has healed and there is no more damage, residual pain means that your body has become extra sensitive. In other words, your alarm system for pain isn’t working the way it’s supposed to be. A good analogy for this: normally a fire alarm would only go off if there was an actual fire (ie. A very real threat). Now the fire alarm goes off even just for burnt toast! 

It’s hard to feel like you can change your pain, especially when it has played a dominant role in your life for a long time. I promise you, that can change.

The fact that so many elements play a role in pain is actually a very good thing. It also gives us so many inlets to tackle the problem. The experience of pain can influence sensations, emotions, and thoughts, BUT sensations, emotions and thoughts can also change the experience of pain in return.

Here’s another example:

Think back to when you were little, and you tripped and fell. If no adult was watching, you just got up and continued along your merry way. But if one of your parents came rushing over to comfort you, suddenly you felt like crying and then everything just felt that much worse.

In order for you to get your extra sensitive alarm system working the way it should be again, we need to come at it from different angles. Ultimately, we need to show your brain that you are safe.

In physiotherapy, we help guide individuals on how to integrate multiple approaches (movement, relaxation, education, coping strategies, manual techniques…) when it comes to chronic/persistent pain to make sure you can take back control of your life.

I hope this helped answer some of your questions about pain. If you want to learn more about navigating recovery, we are more than equipped to help guide you.

Let’s figure out how to change your relationship with pain together!