05 Aug Pain Is All In Your Brain
The Fascinating Facts of The New Pain Paradigm
Piercing, throbbing, shooting, aching, dull, cramping, burning––pain produces a variety of sensations, and by the time we reach middle age, most of us have experienced all of them in some part of our body.
But this is where pain gets interesting––there’s only one place it actually occurs: in your brain. That time when you were a kid and you fell and scraped your knee? It wasn’t your knee producing the pain, it was your brain. When you burned your hand on a hot stove? Again, that was your brain, not your hand that made you screech.
Obviously, there was tissue damage in both your knee and your hand where trauma occurred. But where pain originates and where it shows up are different places. It seems a bit mind-bending to think that torn or torched flesh in itself isn’t producing pain. But indeed, pain is a construct of the brain.
In a nanosecond in both scenarios, tiny nerve endings called nociceptors sensed danger and sent a signal to your brain and awaited a response. Your brain riffled through your history of similar type situations involving the same areas of your body, and it also catalogued your emotional, cultural, biological, and psychological states at the time of the trauma. Then, it made a decision to produce or not produce pain. It also chose the degree and type of pain.
How The Environment Influences Pain
But wait––what have your emotional, cultural, biological, and psychological states got to do with whether or not you feel pain? Your brain accounts for everything at the time physical trauma occurs.
To better understand, I’ll share a short story about a past client to explain (omitting identifying details, and assuming the pseudonym Lucie). For the sake of engaging narrative, I’ll give it a title:
Home is Where The Hip Hurts
Lucie had recently divorced her husband when she went on a series of backpacking mountain treks. She was quite active for several months followed by a long hiatus, which gave her body time to recuperate.
When she returned home and reunited with her family, who were quite unsupportive about the news of her divorce, Lucie took up running again, a favourite pastime sport to help work out some of the difficult emotions she felt. One day during a 10 km job, Lucie’s left hip jolted in piercing pain and halted her run. She limped home and couldn’t get out of bed the next day.
For several months Lucie recovered from an injury that had no medical explanation. She took anti-inflammatories and with regular gentle movement, the pain started to lessen. But from time to time, whenever Lucie returns home, she experiences an old familiar ache in her left hip that limits her movement and causes a great deal of frustration. Over time, Lucie has come to regard her hip pain as always there lurking, ready to arise when triggered. She even starts to feel that ache in the anticipation of returning home.
A second in time can produce a lifetime of agony or a mildly annoying ache for many people who live with chronic pain. In that split second, the brain takes a snapshot of every part of your life, makes a series of sophisticated connections, and determines the right flavour and degree of pain for the current event.
When pain’s circuitry crosses wires with your psychological or cultural state––and it always does––it becomes a very complex phenomenon. It often gets trapped in the subconscious, or lodged somewhere in the body, unknowingly and presents as a physical issue. That’s not to say that pain isn’t real––it is––and anyone who experiences chronic pain can vouch for that. But its cultural origins are a mash-up of factors all hosted by the brain.
The Nature of Pain
The nature of pain is a phenomenon that scientists have been investigating for years. At one time, they believed that pain originated from damaged tissue, and that the nociceptors were responsible for the sensation of pain. Now we know that pain doesn’t happen in body tissues, it’s an output of your brain that serves to protect you. Those nociceptors merely send a warning to the brain that danger is present, they don’t actually produce the pain. Simply put, pain is a construct of the brain 100% of the time. But as you’re probably starting to see, it’s anything but simple.
There are two categories of pain: acute and chronic. Acute pain results from tissue damage and can last for a few days or weeks. Pain that lasts for more than three months is considered chronic. It persists even after tissue damage has been restored.
According to the Canadian Pain Task Force (CPTF), there are also three types of pain. Each is underpinned by a different biological mechanism.
Nociceptive pain is the most typical type that occurs when there’s tissue damage from injury, disease, or inflammation. It feels sharp, aching, or throbbing.
Neuropathic pain results from damage to the nervous system. There is a burning or shooting sensation, and the skin may tingle or feel quite sensitive to light touch.
Nociplastic pain is similar in nature to neuropathic pain, but rather than damage to the nervous system, it arises from a change in how sensory neurons function––they become increasingly sensitive.
Pain also has the ability to expand and become more sensitive over time. That’s why so many people have some degree of persistent pain. According to the CPTF report in June 2019, one in five Canadians experience some degree of chronic pain.
Chronic pain, also called persistent pain, is less about the structural integrity of bones and tissues and more about the sensitivity of the nervous system to various factors. Think back to the previous narrative––Lucie’s chronic pain is much less about physiological factors and more about a time and a place still alive somewhere in her body.
When pain persists, we reinforce pain neurons so they become more sensitive to pain and better at producing it. The point is to protect ourselves. It’s a real, subconsciously integrated learned behaviour to avoid that which has caused us pain in the past, whether it be a hot stove or a particular movement.
Chronic pain can be misleading and unhelpful because it protects you unnecessarily and reinforces the body’s pain response. Over time, these pain networks behave with less specificity, so the pain spreads to surrounding areas and changes quality until it no longer represents a real problem with the body or any perceived danger.
Chronic pain is less about the structural integrity of bones and tissues and more about the sensitivity of the nervous system and the brain’s ability to create pain for any number of reasons. Actual tissue damage is just one reason. Emotional factors, stress, and your personal beliefs about pain influence how we experience it.
Pain recovery requires retraining your brain and nervous system. Piece of cake, right? Well actually, it primarily takes awareness, patience, and commitment. If you’re experiencing chronic pain, the first thing to ask yourself is what may be contributing to your pain experience?
Active approaches tend to have a stronger impact on retraining pain habits than medication. For example, lifestyle. Is there some area that could use a little cleanup? Things like alcohol, smoking, poor diet, and lack of exercise all increase the nervous system’s sensitivity to pain.
Emotional and psychological influences factor in here too. How do you think about pain? Is there fear? Resistance? Avoidance? All three will reinforce the emotional body’s response to pain.
We can go further into the deeper meaning of pain to consider our life story. What events occurred around the time the pain developed, such as in the case of Lucie and her divorce? Recognizing deeper emotions and environmental influences is part of the healing process.
Some experts believe that learning about how pain works in the body can be effective in reducing the sensation of pain. Moving at comfortable levels without fear can help retrain the brain so it does not produce pain as a protective mechanism.
Find out how Marnie at Journey Within Healing Centre can help you learn to manage chronic pain with gentle therapeutic and prevention techniques. Contact her for a chat or to book an appointment.
In the meantime, it’s important to understand that chronic pain has many layers. Be patient with yourself as you learn to manage it. Like peeling back the many skins of an onion, it all happens one layer at a time.