“Our brains have the power to switch pain on or off”

Pain as Protector

Although it might not feel like it, pain has evolved as an important danger signal to help protect our bodies. When we physically injure ourselves by burning our finger on a hot stove, or by hitting our foot against the corner of a table, pain exists to let us know that something isn’t quite right.

Whilst it might feel like the pain is being generated in the area where it is felt, all pain is generated in the brain. In fact, our brain has complex mechanisms that enable it to decide whether or not to switch pain on or off. If you break your ankle when running from a tiger, your brain will likely not generate pain to improve your chances of escaping and surviving. If you break your ankle chasing after an antelope, your brain will likely trigger severe pain to get you stop the chase and rest in order to heal and prevent irreparable damage. This network is commonly known as a ‘salience network’, due to the brain’s ability to decide what is most salient/important to attend to.

“Pain can be generated in the absence of structural damage.”

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“The pain is not just in your head.”

“Emotions and life experiences can result in pain in the same way as physical injury.”

“Chronic pain is pain that has become stuck - your brain has learnt it too well.”

Pathways of Pain Generation

So, the brain can decide whether to activate pain in response to a physical injury. However, pain may also be generated in the absence of any structural damage. Take ‘phantom limb syndrome’, where amputees continue to feel very real pain in limbs no longer there. No structural damage exists; the limb has been removed. So, what’s causing the pain? Neural pathways in the brain and over-sensitised nerve pathways.

Other pathways of pain generation include the processing of emotions and stress. Take stage fright as an example. Common sensations noticed during this experience are stomach pain, rapid heart rate, sweating and nausea. All of these sensations, including the pain, are real physical sensations in your body and absolutely not just ‘in your head’.

Previous life experiences, too, can initiate pain conditions. In animals, emotional and stressful environments during infancy were demonstrated to imprint in the brain, resulting in overly active autonomic nervous system responses. In humans, individuals with adverse childhood experiences such a physical, sexual or emotional abuse, parental divorce, neglect and difficulties at school are statistically more likely to developing chronic pain conditions later on in life.

“Chronic pain can be cured.”

Just as your brain has re-wired to learn pain, it can unlearn it!

Moving from Acute to Chronic Pain

Physical injury, emotional events and life experiences can each result in acute pain. However all tissue damage is healed by 3 months, and you may not feel particularly stressed.. So why is it that pain not going away?

The answer lies in our brain’s incredible ability to continuously learn and re-wire. When the brain experiences pain again and again, neurones begin to ‘wire together’ and become even better at firing together. The end result is a brain that has unintentionally learnt to be extremely good at feeling pain. Even our reactions towards the pain including fear, anger and frustration can act to reinforce these pesky neural pathways, resulting in the worsening of the symptoms and an even more overly sensitised nervous system.

Can chronic pain be fixed?

Of course! Just as your brain has re-wired to learn pain, it can unlearn it. Using a multifaceted approach, we can begin to activate the conscious part of the brain to override the subconscious pathways that produce and maintain pain, and get you on the first step to recovery.