Understanding Pain: The Basics

by | In Depth Articles

Do you (or a family member/ friend) suffer from pain that has persisted for over 3 months? Has resting / doing rehab exercises not really helped? Does massage / getting ‘clicked’ ease the pain for a while but it always returns? If so, read on!


Consider the following statements:

• Pain is NOT an accurate measurement of tissue damage – a minor injury like a paper cut can be excrutiating, and likewise a serious injury may not hurt at all until you see the blood.
• Although it feels like it, pain does NOT come out of body parts like the lower back, hip, knee, or ankle. It is produced by the brain in response to sensory information from the body parts, e.g. touch & chemical receptors, sight, hearing, smell, memory.
• Despite it being a highly unpleasant experience, pain is actually the way the body DEFENDS you against actual/potential damage.
• Though pain comes from the brain, it is NOT therefore ‘imaginary’ or ‘all in your head.’ All pain is very real but it can be influenced by other factors apart from tissue damage.

Hopefully, these statements have encouraged you to start thinking. Here are a couple more questions to add to the mix… How is it that soldiers in battle can be totally unaware of serious injury until they are in a safe place or lying in hospital? Why do the majority of people who have had limbs amputated STILL feel pain in a hand or foot that isn’t even there any more?

Modern Pain Science

Thanks to concepts from modern pain science, we now understand pain far better than we used to. There is still a lot that remains unexplained, but by realising that pain can be affected by many other factors apart from tissue damage, our approach to dealing with pain can/should evolve. We most definitely need to think further than just ‘treating’ the body part that hurts.

What The Research Tells Us

Much of the pain research to date has involved persistent lower back pain, a dehabilitating issue that is hugely prevalent amongst our society. Despite the common assumption that back pain is a product of herniated discs, degenerative disc disease, scoliosis, osteoarthritis and pinched nerves, studies show us through the use of X-rays, CT scans, and MRI’s that there are plenty of people with the aforementioned structural ‘issues’ who are NOT in pain, with many being active, successful sports people.

Understanding that pain is NOT necessarily a sign of damage or degeneration has helped bring relief to many sufferers. Consideration and exploration of other potential factors causing the brain & nervous system to feel threatened has brought pain belief to many. Sometimes understanding that your vertebrae are NOT in danger of ‘slipping’ (whatever that means!) or that the degeneration shown on your scan is perfectly normal and seen in healthy adults of similar age is enough to start reducing pain.

Understanding Pain: A Five Minute Video

The video below was produced by Hunter Integrated Pain Service (HIPS), a multidisciplinary pain management team based in the public hospital system in Newcastle, New South Wales, Australia. Though it does at times over simplify, the overall message is delivered extremely well.

Source: GP Access & Hunter Integrated Pain Service, New South Wales.

The video reiterates the important points we mentioned in our introduction.
• Pain and tissue damage are NOT always related. You can have tissue damage with no pain, just as you can have pain with no tissue damage.
• Persistent pain persists after tissue damage has healed. Remember, most tissues heal within 3-6 months.
• Your pain may well be less about ‘structural issues in the body’ and more about the sensitivity of your nervous system.

Managing Pain

Understanding pain can help enormously whether it has been an issue for a week or many years. Behind any type of pain is a rationalising brain & nervous system. Though in many cases the challenge to change ingrained experience & perception will not come easy, the first step is to appreciate that in the majority of cases pain is NOT something to be feared or seen as a measure of damage. Pain is your brain & nervous system letting you know that according the feedback it is receiving it believes something is dangerous. Looking at all potential factors is key to dealing with pain. In helping you recover from pain issues, modern health professionals should in theory be equipped to help you to see pain as a highly sophisticated warning system of potential danger. And let’s face it, It would be a pretty useless warning system if it only sounded after damage had already been done!


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