The pain and the brain

brain painOver the last 20 years there has been a pain revolution in our understanding and knowledge of pain and how to deal with it.

In the past if someone had unusual pain or symptoms which didn’t fit the textbook pattern, they were often told by doctors or therapists that the pain was in their brain. It was almost as if they had made the pain up or that they were a weak individual for feeling what others didn’t.

We now know so much more about pain and can now explain what’s going on for those people with unusual or long term pain.  The brain is very, very changeable and plays a major role in how we feel pain.

Most people will think that when they hit their thumb with a hammer it’s their thumb that hurts. It’s a logical explanation to think. Those with a modern understanding of pain will know that there is a different story.

When your thumb is hit, little sensors on the nerves in the thumb convey a message of threat to the brain. The brain processes this information along with many other pieces of information such as previous experience, who else is around, any stresses in our lives and what other areas are damaged.

If the brain decides at that point that we are in threat, taking action would be useful and pain is useful to change our behaviour then it will ‘construct’ the feeling of pain onto the virtual body in the brain. It’s so clever that it makes us think our thumb is painful, when actually it’s in an area of the brain.

Knowledge about how the brain and the nervous system works is not only reassuring for many people in pain but it also reduces the threat about pain and helps people reduce the levels of pain or altered behaviour from pain.

One way to get a better understanding of how the brain works and how it changes, is to think of the old pin boxes. These toys were a series of little metal rods which when pressed would form the impression of what they were pressed onto – such as the hand or the face.

They are great at demonstrating the ‘elasticity’ of the brain – its ability to change and also to change back. Just because the pattern is formed one way now doesn’t mean it will be that way forever.

Just because we have some pain now after an injury, it doesn’t mean that we are stuck with that pain forever. Where we feel the pain, its intensity and the sensation of pain can all alter over time.

For some though the pain doesn’t go away when we would expect it to. Sometimes for these people areas of the brain ‘smudge’ and the pain spreads to other areas of the body. If you are one of these people, help is at hand. By improving your understanding of how the brain works you can reverse the ‘smudging’ and take control over your pain. Get in touch and we can start to turn your pain journey around.

Robert Grainger MSc MCSP MHPC CSCS

Practice Principle PhysioFixx Physiotherapy Clinic

Sports Physiotherapist



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