Pain

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Pain complicated and everyone’s pain is different. Pain is your body’s way of protecting you. It can be very helpful in certain situations, like stopping you running on a broken ankle.

Pain works a bit like an alarm system, but sometimes, alarms can go off too easily.

All pain is produced by the brain. This does not mean the pain is imagined, or all in your head. It means the brain is trying to protect you.

Pain happens when the brain thinks there is a real or possible threat. This is why we can feel pain when there is no new injury or damage.

Many people believe that strong pain means a lot of damage. However, we know that this is not always true.

Pain can be affected by many different things; because of this, how much something hurts does not always match how much damage there is.

For example: a soldier may not feel pain straight away after being injured because they are focussed on the danger around them

however, a paper cut can hurt a lot, even though the damage is very small.

Acute pain
… is the pain you feel soon after an injury or when pain first starts. It usually gets better within 3 months

Persistent pain
… is pain that lasts for longer than 3 months. It is less about damage to your tissues and more about changes in your nervous system (the brain, spinal cord and nerves).

With persistent pain, the nervous system becomes more sensitive – like turning up the volume. This can be normal for a short time after an injury. But if the ‘volume’ stays high, pain can continue even after the body has healed.

Many things can make your nervous system more sensitive, such as:

Stress
Low mood
Poor sleep
Feeling run-down
Stiff joints and weak muscles
Long-term health conditions
Ours and others’ beliefs around the pain
Fear and worry about the pain
Your environment
Your relationships (at home and work)

Often, several of these factors work together. This is why improving pain usually means looking at more than one area of your life.

For example, doing more exercise may help, but if you are still very stressed and sleeping badly, your pain may continue.

Persistent pain can lead to a cycle:

.... > doing less > losing fitness > feeling worse > more pain > doing less > losing fitness > feeling worse > more pain > ....

This can also affect your mood and general health which can make your nervous system even more sensitive.

For example, if you stub your toe after a good night’s sleep and you feel positive, the pain may feel mild. However, if you slept badly and feel stressed, the same injury may hurt much more.

Understanding what turns your ‘sensitivity dial’ up can help you find ways to turn it back down again.

Physiotherapists can guide you, but you play the biggest role. Hands-on treatment like massage may help for a short time, but they do not usually give long-term change.

Helpful strategies may include:

improving your sleep
slowly increasing your activity levels
doing regular exercise to get stronger and healthier
managing stress and anxiety
keeping a healthy weight

Pain is complex and is influenced by many factors. It is not only about damage to your body.

Understanding why things hurt can help you spot what might be affecting your pain. By working on these factors, you can help turn down your own sensitivity dial.