15th Jan

2016

Is pain real or just in my head?

Understanding pain is complicated. The medical Journal of PAIN still comes out on a regular basis (and has been for many decades) with new bits of information.
Firstly all pain is real. A poke in the eye, a nail in the foot, a knock to the head – all instantly painful, all real and all painful. Very different from chronic recurring pain.
Secondly, there is an area of our brain which dedicates itself to each part of our body for feeling and for moving (a bit like the GPS coordinates but for our body). The amount of brain dedicated to certain parts of our body depends on the intricacies, sensitivities and needs of that part (thumb, lips tongues are used a lot but the whole area of your back, not really that important).
Thirdly, we all have the same nerve receptors that send discomfort to our brain. This discomfort information is then sent to areas of your brain associated with pain including parts related to memory of previous pain, rewards/losses associated with previous pain and belief systems related to pain especially a recurring pain. Your brain decides on the level of threat of the pain and increases or decreases the alert or relief of the pain
Hence all of your pain is in your head. For most people this feels like an insult. To sooth this over though try to convert the acceptance that our eyes can play tricks on us and experience irregularities that we sometimes laugh off (Mirages, quickly seeing no one driving a left hand drive car or light sensitivity with migraine). Pain is exactly the same though less likely to be laughed off.

In summary – for Physiotherapists pain is the most important renewable resource in the world but the success of therapy can sometimes be about understanding pain rather than the next manipulation or massage.

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