Have you or a loved one ever heard these words from a health care provider:
I don’t see any obvious structural problem—the pain must be in your head.
How does that make you feel?
- Frustrated?
- Not listened to?
- Insulted?
- Ready to find that provider that will know how to fix your body so you no longer have pain?
All of these responses make sense. Unless the provider gave you a clear explanation of what neuroscience has to teach us about pain. That is the topic of this article.
One short and relatively understandable definition of pain is: a person’s response to noxious stimuli. The “noxious stimuli” here can be thought of as the things that hurt: your back, your knee your scratch, whatever. Conventional thought has been that if there is something “wrong” physically that can be correctly diagnosed and treated any pain should go away. If this has not happened, then obviously a proper diagnosis and treatment plan has not yet emerged. So people with ongoing pain may go from provider to provider seeking those.
The truth is that the “noxious stimuli” are not the pain. The pain is a result of how your brain deals with those stimuli. Factors that typically help the brain to tell you to feel pain have to do with past history, social and emotional issues. The key is how much the brain senses that these “noxious stimuli” will endanger your happy pre-pain lives. To make this even trickier, over time the brain itself learns how to have pain.
This 14 minute TED talk by the extremely witty pain scientist Lorimer Mosley, Ph.D. will have you laughing while you get a bit of a more in depth explanation of these ideas.
The book Explain Pain, which Dr. Mosley co-authored, is another excellent resource.
So what do I do with a client who comes with a chronically painful condition? First off I get curious as to whether the pain a person complains about is not the result of something else not functioning optimally. A very simple example would be knee pain caused by how the foot hits the ground. Sometimes it is a question of how a person organizes their movement and posture overall. Hopefully, by using gentle hands on work and easy movement these issues can be remediated and the pain goes away. Typically in these cases the person’s brain has not seriously learned to have pain.
However, I have worked with many folks over the years that benefit from improved movement and posture, but continue to have pain. At this point more verbal education about pain can be quite helpful.
In my work it is important for people to be able to feel differences as a key to improving how they move.
Often I find that folks with chronic pain use the words “feel” and “hurt” synonymously. With these folks I explore sensation in many contexts that have nothing to do with “pain” vs. “no pain”. I also explain the neuroscience around pain and perceived “threat”. Just the knowledge that having pain does not necessarily mean something horrible is going on inside your body often results in having less.
Here is one more video (only about 2 minutes) that I have shared with my clients who have ongoing or frequently recurring pain.
If you have chronic or recurring pain and would like help you please give me a call at 206-842-4608.