Pain is weird and complicated.
Did you know your brain itself can not actually not feel pain?
So, if you think the pain is all in your head, well it is, but it isn’t. We will explain why if you continue to read.
Pain is processed through sensory neurons called nociceptors, which are free nerve endings. These nerve endings send signals to the brain, also known as nociception, and the brain processes the information then basically decides what to do with it. There are various sensory receptors found throughout the body that react to a variety of stimuli, such as hot, cold, pressure and chemical, all of which can give a person the subjective experience of pain.
Did you know pain isn’t always produced as a response to tissue damage?
Yes, you read that correctly. You can in fact have pain WITHOUT having tissue damage.
Typically when we are talking to patients with pain, no matter the diagnosis, we will say the phrase “pain is perception.” You will rarely hear us say “No pain, No gain.” But that’s another topic for a different day.
Your body takes in information from the environment. When it recognizes something as a threat, whether it is an internal or external threat, it can reproduce a pain signal. If you have multiple threats this is where it can get tricky. The brain then has to decide which one(s) are the most detrimental to you. This is why pain isn’t always a response to tissue damage. That is the old biomedical model of pain ie. pain=injury.
Think about it, how many times have you looked down at your leg or even your arm and asked yourself “Where did that bruise come from? How long have I had that?” At the time you may have bumped your leg or arm there was something more important occurring and your brain suppressed that signal in order to prioritize your attention on what it deemed more important. This means that sometimes tissue damage or injury doesn’t always=pain and doesn’t necessarily have to impair your function also!
Here’s a couple scenarios that might help you have a better understanding of what we are trying to explain...
This example below is what Adriaan Luow from International Spine and Sport Institute said to us when we first started studying pain neuroscience education in order to provide better care to our patients...
Let’s say you are crossing the street and you happen to fall and sprain your ankle. After the fall you may look down and notice your ankle swollen and therefore register the pain.
Let’s change the scenario by adding another piece. Now, let’s say you are crossing the street and you happen to fall and sprain your ankle. At the same time you have fallen, you notice there is a bus coming at you. Do you think your brain is going to process your ankle or the bus coming at you first? I hope you answered “the bus.”
This scenario illustrates how your brain can prioritize the information from your body. The bus coming at you takes priority over a potential ankle sprain. The reason for this response is because your brain does not want you to die or get hurt. Therefore, it can suppress those responses coming from the pain sensing neurons up the spinal cord. However, it doesn’t mean that later, after you escape the bus coming at you, you won’t feel your ankle.
In 1995, the British Medical Journal reported the case of a builder in excruciating pain from a 15cm nail, which pierced his work boot. When the builder saw what had happened, a nail sticking straight up through his work boot, he instantly had a pain response. However, when the doctors removed the shoe from the builder’s foot, they found the nail had passed between his toes and missed his foot completely! His brain interpreted the information as a serious threat and therefore set off his pain alarms, but there was no actual tissue damage!
So back to our first statement: Pain is weird and complicated.
Please reach out to us for more information on what pain is and why you may be dealing with it! We are here for you!