Let’s be blunt. Pain sucks. It really sucks. It interferes with every aspect of a person’s life, and it affects others around us. So, what is pain?
Our body has “danger detectors” called nociceptors that send messages through nerve roots to the spinal cord, which, in turn, decides to send or not send messages, or to alter and not send all messages to the brain. The brain reads and processes these messages, compares it with our emotions, thoughts, expectations, beliefs, memories and past experiences, etc. and decides if we are really in danger or not. It relays its decision back to the spinal cord, which carries out orders to either set off the danger alarm by turning on or up the volume of pain or to let the body know all is well by inhibiting pain. The brain protects us from danger by sending pain signals and creating pain. Much of this happens quickly and without our conscious awareness.
When Pain Signals Persist
When danger stops, but our fear of pain continues, we remain hypervigilant and on guard, and our brain maintains high alert, sending pain signals to continue protecting us from further harm, even though we are no longer in danger. Overtime, if our brain continues to perceive that we in danger and continues to create pain, the brain starts rewiring. When pain signals chronically over-fire, neural pathways are established that remain intact long after a body has healed from an injury.
Pain becomes a pattern, or a habit, of the brain even if the danger eventually stops, leading to overstimulated nerves and generalized hypersensitivity.
Even the smallest touch, sensation, or a memory can be linked to feeling pain. David Hanscom (2016) relates an example of this when he discusses the story of a war veteran. Although his physical injuries had been healed for some time, every time he heard a helicopter, anguishing, physical pain would return at the place of his previous injury.2
Over-firing of pain signals may occur without apparent injury or cause. If you experience pain that has no definable cause and someone tells you the pain is “all in your head”, tell them they are correct, for the brain creates pain, and feeling it is not something you are making up. Danger does not necessarily mean an injury or illness. Emotions, such as anger or depression, negative thoughts, beliefs, lifestyle and life stressors can be interpreted by the brain as dangerous, and the brain is sending signals to the body that it perceives a threat and turns it into pain.
Fight, Flight, or Shutdown
People who tend to be emotionally “sensitive” and empathic often are more inclined to experience chronic pain and autoimmune disorders. This is also true for people who have experienced some form of trauma in their life. Additionally, those who demonstrate greater anger and emotional distress in relation to their pain, tend to develop or experience higher levels of pain. Whether chronic pain has developed from physical or emotional trauma or an unknown cause, it is well documented that negative emotions exacerbate physical pain.
Chronic pain signals trigger a continual fight or flight reaction, inducing chronic hyper-arousal of the mind and body and can lead to being withdrawn, depressed, and shutdown because it is too much to mentally, emotionally, physiologically handle. Chronic pain easily leads to habitual fear of pain, avoidance behaviors, depression, and feelings of helplessness and hopelessness.
Living with pain is like living with a blaring alarm clock constantly going off in your head. It disrupts the ability to think, to act, and to calm oneself. The hyperarousal I have felt from pain, often caused me anxiety, which caused more hyperarousal and pain, creating a vicious feedback loop. I could even feel my brain changing, in which I could not think as clearly, my memory was poor, my hearing became hypersensitive, I became hypersensitive to foods and my digestion was poor, I developed Irritable Bowel Syndrome, Fibromyalgia, and allergies became heightened, such as a gluten allergy turning into Celiac Disease. Pain can affect us on all levels.
But wait, there is Hope!
We can play a huge part in modulating pain signals.
Much of that hope comes from realizing that a HUGE part of healing comes from within. Just as psychosocial factors, emotions, thoughts, beliefs, and our perceptions and expectations can all turn up pain signals and pain intensity, they can also turn down pain signals and intensity. Research suggests that a part of the brain called the amygdala, plays a large part in the connection between pain and emotions, as well as anxious behavior. The amygdala “…plays a key role in emotional modulation of pain….the amygdala appears to be involved in the enhancement (hyperalgesia), as well as in the reduction or inhibition (hypoalgesia/analgesia) of pain signals.”
What is Your Self-Recovery Plan?
Self-efficacy refers to a person’s belief that s/he can succeed at something. People who have high self-efficacy tend to exert a high amount of effort for an extended time and demonstrate more adaptive coping behaviors than someone with low self-efficacy.
Although we may feel broken, we are not. We need to focus our hope inward and empower ourselves. We can play a huge role in our recovery process.
To reduce pain, the brain needs to be distracted from thinking that we are in danger; we need to take action and progressively engage in activities, that over time, tells our brain that we are safe. Active coping skills, movement that feels good, people that make us happy, a safe environment, optimism, joy, humor, mindfulness, creative expression, journaling, decreasing stressors in our lives, enjoying nature are all ways to send signals to the brain that we are safe and the pain alarm system can be turned down. So many options we have to start working on feeling safe!
Pain is not just a physical experience, but also an emotional experience.
I once took a vacation to a beach resort, where all I basically could do, because the pain was so severe, was lay on the beach, lay in the water or snorkel, nap once a day, and go out to dinner at night. My vacation gave me the experience of safety. Away from hospitals, doctors, therapists, and everything that reminded me of pain and my injuries allowed me to stop thinking about them. Instead, my brain was distracted with warm sun, relaxation, and engaging in activities that brought me a sense of connection with nature and joy. This increased my emotional resilience and ability to cope with pain during my trip.
It distracted me from always noticing and feeling the sensation of pain. It decreased my overall physiological state of hyper-arousal and hypervigilance, allowing my mind and body to relax, so much so that my physical therapist noticed reduced muscle tension, greater physical alignment, and improved ability to walk.When we provide ourselves respite in an environment that feels safe, and when we are able to create an emotional state of joy and calmness, we can directly and positively affect our brain and physical state, and improve our quality of life.
When considering this mind-body connection of pain (this painful connection, if you will), remember that our thoughts, perceptions, and beliefs directly influence our emotions. The influence that the mind-body connection has on our health cannot be underestimated. To emphasize the significance of this connection, perhaps we should also consider pain intensity as an emotion—or an emotional reaction—to our state of mind.
Try engaging in activities that bring you joy and peace. Start for 5 minutes and work your way up to longer activities. And remember to always give yourself compassion. To help increase your relaxation response and decrease the flight/fight/shutdown response, check out some of my meditations.
Our emotions, thoughts, beliefs, and attitudes all affect pain and have the potential to be natural painkillers.
BELOW IS A LIST OF STIMULI THAT INFLUENCE PAIN:
May Increase Pain
May Decrease Pain
Gentle touch, vibration, heat or cold
Negative thoughts, Pessimism
Positive thoughts, Optimism
Fear, Anxiety, Worry, Anger
Confident, Calm, Relaxed, Happy
Past Emotional and/or physical abuse/trauma
Emotional or physical tension
Emotional or physical relaxation
Over-focusing on pain
Actively coping with emotions
Low self-worth, rejection of body & self
Self-compassion and love,
Self-acceptance, strong sense of self -worth
 Lehman, Greg. (2017). Recovery Strategies Patient Guidebook, Section 1: Pain Principles, pg. 10. Retrieved from: www.greglehman.ca
 Hanscom, David, MD. Back in Control: A Surgeon’s Roadmap Out of Chronic Pain, 2nd Ed. Vertus Press: 2016.
 Strobel, C., Hunt, S., Sullivan, R., Sun, J.Y., & Sah, P. (2014). Emotional regulation of Pain: the role of noradrenaline in the amygdala. Science China. Life Sciences. April 2014 (57)4: 384–390. doi: 10.1007/s11427-014-4638-x.
 Moseley. Lorimer. 2015, November 18. Explainer: What is Pain and What is Happening When We Feel It. Retrieved from: https://theconversation.com/explainer-what-is-pain-and-what-is-happening-when-we-feel-it-49040