Pain and the Brain

Your Brain and Pain—

Let’s talk about pain. It’s the most common reason people come to see physical therapists. Because their body hurts. But to treat pain, first one must understand it—how it’s processed through the body, and communicated to the self, how that message is then interpreted, and what that all means for recovery….

Pain is a multi-faceted, elusive little creature. It used to be, pain was considered to start at the nerves of injured tissue. But new science reveals it’s a little more complicated than that. Pain is a signal that is transmitted through nerves to the spinal cord and then on to the brain. So the nerves don’t produce the pain, they simple carry messages from tissue to the brain. It’s the brain that decides whether that message is a “danger” message or simply an “informational” message. When the brain decides incoming information is a danger message, it produces pain in order to affect change on the body. (For example, when your hand touches fire, the brain receives the danger message and then promptly produces pain so you will move your hand away from the fire).

However, as more research is done on the relationship between pain and the brain, it is being discovered that, in certain instances, the brain can produce pain even without tissue injury. If an injury is particularly traumatic, or if there is strong emotion associated with the event, the brain is more likely to remember the danger messages coming in from that particular set of tissues – even after the healing process has completed. From then on, whenever nerves from that set of tissues send information to the brain, the brain is likely to interpret it as a danger message. Conversely, since the brain knows that was an area in danger, it starts asking the nerves for more information more frequently. Soon, you have a highway between that body part and the brain, and you have a brain that is very worried about the tissues in that area.

This highway leads to sensitivity. Sensitivity can be in response to a number of stimuli – touch, pressure, movement, temperature, emotional state, and even weather changes. The highway also means that any and all messages from that area of the body are reaching the brain, as opposed to the standard operation, wherein the brain has gatekeepers—namely neurons in the spinal cord, to help reduce unwanted information. The deluge of input means the brain gets a little confused as to what was a normal bit of information versus what was a danger message. Soon, everything is a danger message!

It sounds like pain can get out of control, can’t it? Sometimes it does, and that can be incredibly frustrating for the patient. Luckily, there is action to be taken. Step one, get informed! Knowledge is power. Patients who understand where their pain is coming from and why, are often less worried about their pain, which leads to reduced sensitivity. Quality sleep, regular exercise, deep breathing (through the stomach, feeling those ribs expanding, those lungs puffing up—), and relaxation all help to reduce the amount of input that is being sent to the brain.