Pain is typically thought of as a sensation caused by damage to the body. However, through modern science we have found that there are multiple factors in and outside of the body that lead to your brain’s ultimate decision to “feel” pain or not. Pain is more accurately defined as “an unpleasant feeling in our body that makes us want to stop and change our behaviour.”1 In this sense, pain is a protective mechanism that is utilized by the brain to try and influence a person to stop what may be causing the pain in the first place.
The feeling of pain is not possible without the brains input. Have you ever found a bruise somewhere on your body, but not remembered how it happened? This is a great example of how pain works. Without the brain’s conscious awareness of an injury, pain is not possible. You may have hit something inadvertently and damaged the tissue, but you never felt pain until you saw the bruise. The way this works is that you have nerves in your body called nociceptors, and those nerves send messages to the brain when they detect danger. The brain doesn’t just receive danger signals, but also signals of temperature, chemical balance, and many others. The brain’s job is to then look at all the signals and determine whether or not it is necessary for you to feel pain. When you have irritation or damage in a body part, the feeling of pain always comes from the brain’s decision to make you feel pain.
The brain is aware of things going on not just inside the body, but outside of the body too! Pain is situational and can be increased or decreased based on a variety of external factors. For example, if you’ve ever been stung by a bee in the woods, your brain will remember that situation. The next time you’re walking through the woods and something reminds your brain of the bee sting (like a twig that pokes your leg), your brain may unnecessarily create the feeling of pain so you get out of the situation. This is only possible because your brain used context clues and memories to try and predict what would happen next. This is a very simplified example of how our brain works to try and protect our body; in reality, our brain is an incredibly complex system. The takeaway message is that without the brain we can’t have pain.
Sometimes our bodies are in pain for so long that it seems like the pain never goes away. Just like we train a muscle to get stronger, we can train our brain to be better at different tasks. The more our brain creates pain, the better it will become at producing it. Even long after tissue has healed from an injury, our brain can continue to create pain as if the tissue were still acutely damaged.
Research supports graded exposure as one of the best treatments for chronic pain. Graded exposure is simply explained as: slowly introducing activity and increasing activity levels over time. The reason for this approach is that we can reteach the brain that activity doesn’t need to be painful. Remember that the brain recalls certain situations as painful, and sometimes this is a bad thing. An example of this would be the action of walking immediately after an injury and having pain. The brain can then remember this well after the injury has healed, and will unnecessarily create pain when it’s no longer needed as a protective measure. Graded exposure is a way of showing the brain that activity doesn’t have to be painful anymore, and over time can reduce how much pain you feel with an activity. This is not a fast process, but a necessary one to combat chronic pain.
Our physical therapists at Virginia Therapy & Fitness Center are educated in pain science and understand that pain is a very complex process of our brain. It is essential to feel pain after an injury to protect our body, but when our brain makes us feel unnecessary pain a physical therapist can help alleviate your pain and get you back to a happy and fulfilling lifestyle!