PAIN: Is it all in my head?

"Pain is really strange" (S. Haines, 2015)

When I was 13 I had my first experiences of 'chronic pain'. I had injured my ankle, and then not long after dislocated my shoulder. The pain was excruciating at both these sites but then I started to feel pain everywhere, it spread so I had pain in all my other joints. It did not make sense, I had only injured two areas and now everything hurt?!

At the time, Doctors tried to explain to me that the pain I felt was not due to direct damage to my body, but that my brain is now confusing any signal as pain signals. I was convinced that they meant I was making it up or exaggerating my pain. I felt misunderstood, as I wanted more than anything to be pain free again and return to my sports and dancing that I missed, why would my brain make up that it was in pain?!

It has forever been a sensitive topic to me. Anytime any sort of doctor implied it was in my head I would immediately stop speaking to them during an appointment, leaving mum to awkwardly cover for me. It is only after years of living with pain and then learning the physiology behind pain as a physiotherapist can I clearly see what those Doctors meant all those years ago.

I think the language used when describing pain is so important, 'its all in your head' is kind of accurate but has negative implications, implying we want to be in pain or are faking it. Instead its more helpful to describe how your brain becomes overly sensitised to pain and to understand pain.

What is pain?

Pain is normal. It keeps teaching us, how to be smarter and look after ourselves. It is designed to prevent us from getting into danger or harming our bodies, for example a burn from spilling boiling water or back ache from sitting too long. It is essentially a clever ‘alarm system’ for us.

  • The nervous system is in control of the pain you feel, both the peripheral nervous system (nerve pathways throughout the body) and the central nervous system (the brain and spinal cord)

  • The peripheral nervous system is sent a message from one of the sensors that pick up on a sensation. This then sends chemical messages up through the spinal cord to the brain.

  • The brain then makes a value judgment based on the input of the message, the context and previous experience. It then responds by sending messages back telling the body to react whether its pain, moving a limb, sweating, speaking etc.

  • It is a myth that there is one ‘pain center’ in your brain, whereas in reality pain uses hundreds of brain parts simultaneously – these are called ignition nodes.