What is pain?

What is pain?

This may sound like a fairly straightforward question, however, when you think about it pain can actually mean a wide range of things. This also differs from person to person.  In fact, I find for some of my clients, my assessment of their posture, gait, or restricted range of movement of a specific joint can actually give them validation for them feeling pain; which I find odd.  It's almost like they don't believe what their bodies are telling them. I've lost count of the times I hear something along the lines of 'Great, so I'm not making it up then?'

Perhaps this response is born out of the British 'stiff upper lip' culture of keeping quiet, carrying on and not making a fuss.  Whatever the reason, we could all do with understanding and listening to our bodies more. In this blog I'll give you a list of 10 points, to try and help explain (and therefore understand) pain.

At this point I must confess, the information I'm presenting is not my own.  I recently received an email from pain experts (Lorimer Moseley and David Butler) at the noi group (Neuro Orthapeadic Institute). In this email they attempt to explain what pain means using short and precise points. I was so impressed by it, that I thought I'd just reiterate what they said, rather than try to imitate it! So here goes:

1. Pain is normal, personal and always real

All pain experiences are normal and are an excellent, although unpleasant response to what your brain judges to be a threatening situation.  All pain is real.

2. There are danger sensors not pain sensors

The danger alarm system is just that - there are no pain sensors, pain pathways or pain endings.

3. Pain and tissue damage rarely relate

Pain is an unreliable indicator of the presence or extent of tissue damage - either can exist without the other.

4. Pain depends on the balance of danger and safety

You will have pain when your brain concludes there is more credible evidence of danger than safety related to your body, and thus infers the need to protect.

5. Pain involves distributed brain activity

There is no single 'pain centre' in the brain. Pain is a conscious experience that necessarily involves many brain areas across time.

6. Pain relies on context

Pain can be influenced by the things you see, hear, smell, taste and touch, things you say, things you think and believe, things you do, places you go, people in your life and things happening to your body.

7. Pain is one of many protective outputs

When threatened the body is capable of activating multiple protective systems including immune, endocrine, motor, autonomic, respiratory, cognitive, emotional and pain. Any or all of these systems can become overprotective.

8. We are bioplastic

While all protective systems can become turned up and edgy, the notion of bioplasticity suggests that they can change back, through the lifespan.  It is biologically implausible to suggest that pain can't change.

9. Learning about pain can help the individual and society

Learning about pain is therapy.  When you understand why you hurt, you hurt less.  If you have a pain problem, you are not alone - millions of others do too.  But there are many researchers and clinicians working to find ways to help.

10. Active treatment strategies promote recovery

Once you understand pain, you can begin to make plans, explore different ways to move, improve your fitness, eat better, sleep better, and gradually do more.


Noi group


James Barnett