Pain? It's all in your head!

Pain? It’s all in your head.

 

One topic I’ve discussed a lot this week is pain. It’s not a subject I like to discuss usually, because of reasons I’m about to explain. But it is often the driving force for people coming to see us in the first place. 

 

Pain isn’t just about tissue damage. In fact, the level of tissue damage has no correlation with the level of pain someone experiences. This can be hard to understand sometimes, but the easiest example of this is phantom limb pain. Some amputees still experience pain in the limb that has been removed. 

 

This sounds impossible, but it’s the reason why I don’t focus on symptoms with any clients I see. 

 

It doesn’t mean the pain isn’t real, any person with phantom limb syndrome will tell you that the pain they feel is very very real. But it does mean it’s not accurate. The limb is no longer there, it doesn’t exist, so how can it possibly produce pain?

 

This is where the brain comes in. 

 

We have lots of different types of receptors in the body that respond to different things. Some respond to temperature, some to pressure, some to different chemicals, as well as many others. When one or more of these receptors is stimulated enough, it will send a signal to the brain. It’s important to understand that the signal doesn’t say ‘PAIN’, it just says ‘something is happening in this part of the body’.

 

The pain comes from the signal being sent back down from the brain, if the brain thinks there is a threat. But the information coming up from the tissue doesn't give the brain enough information, so it has to draw on past experiences. It will recall any previous situations when it received a signal from that part of the body, about that type of stimulus, in that external environment, and so on. It then used this information to determine whether the current stimulus is a threat, or if it can be ignored. 

 

If it perceives a threat, the brain will send ‘pain’ signals back to that part of the body as a protective mechanism. Pain usually stops us moving and makes us protect the area, which reduces the risk or further damage. 

 

But this is where it can start to get confusing. If you have significant previous experiences, like dislocating or fracturing an elbow, your brain is more likely to interpret any signals from that part of the body as a threat, even if this time you’ve only bruised it. Your brain remembers how bad it was last time, so even though now it’s just a small bruise, your brain has gone into panic mode and is telling you that your elbow is in just as much danger as last time.

 

The pain is still very real, but it’s not very accurate.

 

We take this into account when we assess your current symptoms, or any new injuries you get whilst under our care. It's also why all of our recommendations are based on how you function, rather than how you feel. It’s not that we don’t care about your symptoms, we still need to know how it’s impacting you, but we can’t base any recommendation off of your perception of the situation.